The Straight Scoop: Man to Man

I recently watched a GLP-1 “influencer” specifically addressing men about weight loss induced by his favored pharmaceutical method. His aim was apparently to give the boys the straight locker-room scoop on GLP-1 weight loss, a subject he treated as if it were heretofore somehow too emotionally delicate for the masculine constitution.

His instincts were valid, since most of the social media noise about GLP-1 weight loss is oriented toward women. And judging by his video’s comment thread, the “straight talk” resonated with many attention starved guys who felt left out by the prevailing emphasis on how good we’ll all look in our bikinis next summer.

First, our manly man hero addressed the stigma issue: the notion that using GLP-1 drugs is “cheating,” “taking a shortcut,” or using an unmanly crutch. His point was that men should not concern themselves with social disapproval. Yeah, right. Come on, man! Do you really care what anybody thinks, fellas?

Then, to dispose of any lingering unmanly shame, he rolled out a sophomoric power-tool metaphor. After all, nothing spells manhood better than a pulsating hammer drill in a sweaty hand! Our influencer posited that no one would criticize you for using a chainsaw instead of a hand saw to fell a tree. And, oh, by the way, it would take forever to build a house using only hand tools, wouldn’t it? So there we have it. GLP-1s are the power tools for conquering the “disease of obesity.” Nothing feminine about that!

Fine. I’ll buy the metaphor. GLP-1s are indeed power tools. But tools do not decide what gets built. They are just tools. Without skill, judgment, and some awareness of their limitations, tools can be ineffective or dangerous. So why read the safety instructions when we can just crank up the chainsaw and admire the noise, the smoke, and the flying chips? Go for it, man!

Burp!

Weight Loss First, All Else Later

The testosteronically enabled GLP-1 evangelism was amusing until Peptide Man touched a nerve by prioritizing weight loss above all else. His message was essentially: lose the weight first, then maybe start thinking about exercise later. Like his referral commissions depended on it (duh!), he did not want to scare people away from pharmaceutical weight loss by declaring that consistent strength training should be part of the process from the beginning. Instead, he minimized training and emphasized enjoyable activities like pickleball or golf—eventually. When you’re ready. Let’s not rush.

Now, I am not here to denigrate pickleball, golf, walking, cycling, or any other decent recreational exercise. They are good ways to get our asses in gear, and many provide meaningful aerobic benefits. But they are not serious strength builders. Especially for those of us in our so-called golden years, a commitment to resistance training is essential to combat sarcopenia, the age-related loss of muscle. Rapid weight loss from GLP-1 therapy can accelerate muscle loss along with fat loss, combining with sarcopenia for a double-barreled threat.

“If the end result is frailty, we have not achieved health. We have merely reduced mass.”

The threat is not just a little loss of strength. It is a seriously compromised lifestyle.

In short, GLP-1s change how much you weigh. Resistance training determines what that weight is made of. Ignore that, and you are solving the wrong problem.

Strength Training is an Optional Extra

Our influencer further trivialized serious training by mentioning that some people starting weight-loss programs cannot even bend down to put on their socks. This was intended to justify putting weight loss first and treating strength training as an afterthought. But that argument cuts both ways. If someone is already functionally impaired, the goal should not be merely to make that person lighter. The goal should be to make that person more capable.

A morbidly obese individual certainly faces many weight-related complications. But “damn the torpedoes, full speed ahead” is not a comprehensive medical strategy. Blindly pursuing scale weight reduction while ignoring muscle loss can trade one problem for another. If the end result is frailty, we have not achieved health. We have merely reduced mass.

If you lose 30 pounds and 10 of those pounds are muscle, you did not just get lighter. You got weaker.

Metabolic Implications

Your metabolism does not care about your scale weight nearly as much as influencers would have you believe. It cares about lean mass. Muscle is metabolically active tissue. The more muscle you lose, the more you compromise strength, function, glucose disposal, and long-term weight maintenance. That is not a trivial side effect. That is structural damage masquerading as success.

And let us not forget that many people who start GLP-1 drugs discontinue them within a year, for reasons ranging from side effects to cost, insurance barriers, supply issues, or simple dissatisfaction. Those who believe the drug alone produced “magical” weight loss often regain much of what they lost. Unfortunately, the weight lost included muscle, while the weight regained tends to return mostly as fat.

So the real risk is not merely losing weight. The real risk is what you are made of when the drug stops.

The Holistic Approach

Returning to the power-tool metaphor, GLP-1 influencer-evangelists often treat the safety instructions like an unboxing-video nuisance: toss them aside and get to the fun part. Weight loss is the fun part. Muscle preservation is the boring technical manual. Naturally, the boring manual is the part that keeps you from cutting your leg off or losing an eye.

Resistance training is essential, and that does not apply only to people on GLP-1s. Any form of meaningful weight loss can involve loss of lean mass. Faster weight loss generally increases that risk. And even without weight loss, aging steadily erodes muscle unless we give the body a reason to keep it.

I am not trying to turn everyone into a gym rat. I am trying to convince people to take strength seriously.

You do not need to train like a bodybuilder. You do need to give your body a reason to maintain muscle. Two or three resistance-training sessions per week is a reasonable starting point. The program should include basic compound movements involving large muscle groups, with loads increased progressively as tolerated. The keys are consistency and commitment. “I’ll get to it if I have time” is not a training plan. It is a prewritten excuse.

A few hours per week is an ounce of prevention against what could later require a ton of cure. Lose enough muscle and your strength, balance, mobility, glucose control, and independence go with it. Sarcopenia is not cosmetic. It is functional decline.

Those few hours might seem hard at first. But you will find that you start feeling better almost immediately. And the long-term payoff far outweighs any perceived inconvenience.

GLP-1 evangelizing “influencers” love to proselytize the joy of uncomplicated weight loss. Their YouTube channel generates more revenue for them if they sweep the hard truths under the rug. As well, their commissions from compounders would suffer if people weren’t sold such a bill of goods about shucking excess pork with little or no personal responsibility beyond sticking a weekly needle in their spare tire. Don’t buy that line of crap!

To sum it up: if you are using a GLP-1 and you are not doing resistance training, you are leaving part of your health behind.

My Progress on Mounjaro

I am somewhat delinquent in updating you on my personal situation. As you might recall, I have been on Mounjaro since June 2024. I’ve lost over 70 pounds and reduced my HbA1c to 5.5% from 7.6%. What I want to focus on today is my improvement in insulin sensitivity, which I attribute more to my resistance training than to the drug-induced weight loss.

Last week, I had blood tests for fasting insulin and glucose. The results were 6.3 uIU/mL and 92 mg/dL, respectively. A commonly used calculation that uses these two numbers to depict insulin resistance, called HOMA-IR (Homeostatic Model Assessment of Insulin Resistance), gives me a number 1.43, which is comfortably in the “insulin-sensitive human” range instead of the “modern metabolic train wreck.”

In November 2024, my HOMA-IR was 4.4, which is a horrible number indicating severe insulin resistance. I had begun my resistance training in earnest in August 2024, so it hadn’t yet had its impact on my crappy numbers. By February 2025, my HOMA-IR was 2.9—still in the metabolic train wreck range, but trending down.

My current result of 1.43 is right on the top end of where a normally insulin sensitive human being should be. HOMA-IR, though, is a model that assumes liver output is stable, and there is no hormonal interference, including GLP-1s bending reality. However, I’m on Mounjaro, which suppresses glucagon, slows gastric emptying, and alters insulin dynamics. So my true insulin sensitivity is probably even better than what the HOMA-IR suggests. The model wasn’t designed for pharmacologically enhanced humans.

I cut fasting insulin by two-thirds without sacrificing glucose control. How? Pharmaceuticals aside, my resistance training played a huge part in it. All the more reason why influencers should be emphasizing, not minimizing muscle maintenance.

Peptide Purgatory is a regular feature of this blog. For an annotated catalog of all my Mounjaro, GLP-1, and Peptide Purgatory updates, please visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: GLP-1 Weight Loss with Minimal Activity? appeared first on The Nittany Turkey.

I came across one such comment as I was looking for reactions to the FDA moves for a story I wanted to write here. However, this comment and the response by the “influencer guru” incensed me, so I’ll write about it instead.

Here’s the comment:

“My current provider for [tirzepatide] compound is refusing to prescribe me any more of the medicine since my BMI is 21.9 and I’m 71 years old. When I told her I thought we were treating the disease of obesity all she said was ‘but you are not obese.’ Clearly she doesn’t get it at all! She told me all kinds of scary possible side effects and told me no ethical health provider would prescribe me the medicine. She told me ‘maintenance dose’ was a made-up term not honored by the FDA. That she would not risk my health or her license by pretending such a term exists. What am I to do?”

The highly intelligent influencer’s response was to “please find a obesity certified doctor.”

Oy, vey!

So let me get this straight. Someone who is not obese yet who is suffering from the “disease of obesity” needs “a obesity certified doctor” to feed their addiction?

What is “A Obesity Certified Doctor”, exactly?

Short answer: not a recognized medical specialty in the same sense as cardiology or endocrinology. It is a certification from the American Board of Obesity Medicine, which means:

• A licensed physician (any specialty)
• Completed CME hours in obesity medicine
• Passed an exam

That’s all. No residency, no fellowship requirement, and no standardized clinical training pathway like, say, endocrinology.

Is it useless? No.

Is it the holy grail these YouTube evangelists imply? Hell, no.

It is basically a continuing education credential with branding.

Now, Let’s Look at Our Commenter’s “Obesity Disease”

A BMI around 21 at age 71 is normal, possibly bordering on “don’t lose any more weight unless you enjoy sarcopenia.”

So, this person tells the clinician they want to continue a potent GLP-1/GIP agonist indefinitely?

The intelligent response: “No ethical provider would prescribe this.”

She amplified this by expressing concern for her patient’s health and her own medical license.

Of course, this incensed the desperate patient, who believes all the bullshit fed to her by YouTube influencers. In this case, she was brainwashed into believing the mythical “maintenance dose” for her “disease of obesity.”

The “Disease of Obesity”

You’ve read my thoughts in prior columns regarding “the chronic, relapsing disease of obesity, which requires lifelong treatment.” Indeed, this has been one of my more popular Bullshit Corner topics. I regard it as more of a marketing opportunity in an expanding world of human porkers than a pathological classification.

But let’s pretend for a minute that current vogue classifying obesity as a disease is valid.

Treatment would be indicated if there were evidence of disease. This case, influenced by influential influencers, lacks such evidence. The only evidence I see here is evidence of addiction abetted by evidence of marketeering.

Think of it this way. You don’t treat

• “hypertension” at 90/60
• “hypoglycemia” at 110 mg/dL
• “obesity” at BMI 21

Unless your treatment paradigm is, “keep the injections coming because of good vibes.”

Maintenance Dosing — real or imaginary?

The provider is technically correct, which to an engineer is always the most satisfying, if not people-pleasing, kind of correct.

The FDA does not define a formal “maintenance dose” concept for GLP-1s in the sense these self-educated influencers use it.

On the other hand, clinical trials maintain patients on doses to sustain outcomes, but that’s not the same as, “You must stay on this forever regardless of clinical context.”

Yep, there’s a big difference between continuation of therapy based on indication and lifetime subscription model for a drug.

Guess which one telehealth businesses, compounding pharmacies, and their willing, commission-earning dupes in the “influencer” business prefer?

The Crux: Indication Drift

What we have here is social media abetting classic scope creep. It goes something like this:

1. Drug approved for obesity and diabetes
2. Works well
3. People like how they look and feel
4. Community forms
5. Identity attaches to drug
6. Now, stopping the drug feels like malpractice

At that point, you’re no longer treating disease. You’re maintaining a pharmacologic lifestyle.

To paraphrase songwriter Paul Simon, “Mama, don’t take my tirzepatide away!”

The Adult in the Room

The physician is clearly the adult in the room. She evaluated risk versus benefit, saw no current indication, and refused to prescribe a drug that can produce serious side-effects. In other words, she’s practicing medicine instead of running a subscription service.

Good for her.

The Uncomfortable Physiology Piece

At BMI 21 in a 71-year-old, further weight loss risks lean mass loss, something you know I’ve been harping on here continually. Additionally, GLP-1s can reduce appetite enough to compromise protein intake. The combination of the two lead to sarcopenia, frailty, and falls. At 71, those are all at issue, even before adding GLP-1s to the picture. The doctor recognized this and acted responsibly.

Not so, our friendly influencers. They’ll push “obesity certified” docs who prescribe, prescribe, and prescribe. Nothing rare or new. Not impressive. Ho hum.

Conclusion, I Hope

“Obesity certified” is a credential, not a specialty, but even so, an ethical doctor who holds that credential would likely not see BMI 21 as a legitimate indication for tirzepatide therapy in most cases.

“Maintenance dosing” is partly real, but mostly abused in this context.

The provider who rejected the prescription request was doing her job correctly.

The whole exchange reads like a support group where the shared condition is not wanting to give up the drug.

The feedback loop is not only unstable, it is oscillating wildly.

Peptide Purgatory is a regular feature of this blog. For an annotated catalog of all my Mounjaro, GLP-1, and Peptide Purgatory updates, please visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: YouTube GLP-1 Fanboys BS Advice appeared first on The Nittany Turkey.

“Organizations that do not react timely to changing circumstances set themselves up to fail.”

Tradition Killed Eastman Kodak

A couple of decades after photography pivoted from film to digital, the corporate founder and leader of the modern photography industry, Eastman Kodak, failed. Kodak did not fail because it misunderstood the future. It failed because it could not abandon the structures that defined its past. Thus, tradition killed Eastman Kodak.

Organizations that do not react timely to changing circumstances set themselves up to fail. As our subject organization enters its second half-century, some serious creative thinking could avert failure.

First, the organization must engage in honest introspection. This requires disciplined thinking, a quality that is quite rare among part-time volunteer policy makers.

Declining Participation and Volunteer Labor

In the Absurdist Papers thus far, a recurring theme is the “overloaded operator”. As participation declines and the organization’s volunteer talent pool contracts, individuals accumulate responsibilities. This leads to overload, dilution of effort, absence of new, external inputs, and ultimately, stagnation. Worse, it can imperil accountability and cloud communication.

Some examples of “operator overloading” follow.

• The Vice President is also an Area Awards Manager, member of the Awards Committee, Net Coordinator, and member of the Bylaws Review Committee. Furthermore, he functions as a regularly scheduled net control operator.
• The Treasurer is also an Area Director, Membership Coordinator, Club Information Officer, Net Coordinator, and a regularly scheduled net control operator.
• Finally, in three geographic call areas, Area Directors have appointed themselves as Area Award Managers.

These are not isolated cases. They are the predictable outcome of a system that assigns responsibilities based on availability rather than suitability. And while the organizations dilettantish leadership decries single points of failure for its more trivial systems, it allows these crucial positions to be concentrated. Draw your own conclusion about priorities.

Although all such cases represent severe compromise, I view the third example of operator overloading as the most potentially damaging to the organization. It muddies accountability and oversight while dubiously “solving” the staffing problem.

What Can We Do about It?

Eliminating the policy loophole that allows a director to serve as award manager is just one component of what I will propose here. It makes no sense and will not be possible in the restructured award organization. The awards organization must be examined and rebuilt, eliminating bad practices while shucking old biases.

The remainder of this Absurdist Paper is a proposal for restructuring the awards suborganization, aiming at creating an accountable, communicative, and efficient subsystem that reduces the demand on a limited talent pool.

Two key concepts are introduced below. Due to wide variability in the existing division of responsibilities by amateur radio call areas, we propose consolidating call areas into regions to even the load and better leverage available talent. To do so will obviously require changes in reporting responsibilities for Area Awards Managers. Under the revamped plan, the Area Directors will be unburdened with the responsibility for managing them, and a more natural, organizationally sound structure will be implemented.

The Case for Decoupling Area Director and AwardS Manager

Let’s address that issue of the amalgamation of Area Directors and Area Awards Managers, which currently exists in three call areas.

In our subject organization, elected Area Directors are largely autonomous, responsible to the membership that elected them and reporting only to the remainder of the Board of Directors. Their primary responsibility is communication with area members and serving as their representatives on the board. Bylaws require that each Area Director appoints an Assistant Area Director to represent the area members in their absence, and an Area Awards Manager to process award applications for the area.

Nothing in the current bylaws precludes an Area Director from appointing themselves to perform the duties of award manager. As I have regularly mentioned here and in earlier Absurdist Papers, this is a major organizational flaw.

Although this dual role arrangement has only manifested as a chronic problem in limited cases, its success or failure is entirely dependent on the individual involved. All elected directors are not equally capable, particularly when declining interest results in candidates running unopposed. which now happens in more elections than not.

If we do not care who we elect, handing them two crucial roles is even stupider than allowing flawed candidates to run without opposition. We compound the felony by allowing irresponsible sinecures, then allowing them to add critical functions to their non-performing portfolio of malfeasance. When failure predictably occurs, we sweep it under the rug.

Accountability Suffers

When the Area Awards Manager is his own boss, accountability becomes a matter of personal integrity rather than organizational design. Systems that rely on individual virtue instead of structural accountability eventually fail. The organization feels “lucky” when volunteers step forward to run for area director, breathing a collective sigh of relief that they have dodged another bullet. We take what we can get.

Once elected, the existing system allows deficient directors to further propagate their inadequacies by appointing themselves to a position where actual work is required. But they were never much interested in real work, so the result is predictable.

Furthermore, many directors are uncomfortable with personnel management. My aim is to unburden them with personnel management by moving Awards Managers’ reporting responsibilities away from Area Directors to the Awards Secretary.

The De Facto Truth

During my decade-long tenure as Awards Secretary, I encountered several situations with awards managers who committed serious offenses or negligence that created a clear, urgent case for their dismissal. Organizational structure precluded me from firing those managers myself. Instead, I needed to make firm recommendations to the area directors responsible. Beating an already dead horse, if the Awards Manager and Area Director are the same person, such recommendations understandably, but frustratingly, fall on deaf ears—and they did.

In the organizational overhaul I describe below, we consolidate areas into regions and redraw lines of authority and responsibility to create a more responsive and accountable revamped award system while eliminating the abominable dual-role Area Director/Award Managers.

Area Award Managers vs. Regional Award Managers

Instead of attempting to find eleven qualified award managers among the organization’s scarce available human resources, I propose consolidating the current areas into “regions”, based on projected workload.

When the FCC laid out amateur radio call areas eighty years ago, population densities significantly differed from those today. For example, the fourth call area was largely rural in 1946, but it is now the most active of all the U.S. call areas. Dramatic population shifts have occurred, yet they are not reflected in the static call area map.

While the FCC has changed its administrative structure to be less dependent on call area boundaries, our organization has neglected to follow suit. As you can see in the chart below, three-year award counts are widely inconsistent among call areas, from an astonishingly low 23 in the 6^th Area to 856 in the 4^th Area. Yet each call area’s awards are administered by a single Area Awards Manager. The large variation demonstrates the current structure’s workload inequity. For this organization, geographic boundaries define responsibility, but do not reflect demand.

Inequities in the Existing Geographic System

A Sixth Area Awards Manager might process six award applications per year, while the Fourth Area Awards Manager can process that many in a single day, day in and day out. The real-life workload will have peaks and valleys, but the the point is still clear. Clinging to the current geographic structure not only wastes scarce talent, but also embeds inequity.

Analysis of Awards Issued between January 1, 2023 and December 31, 2025

Combining areas intelligently could result in a regional structure resembling the following, shown with three-year aggregate award totals:

Northeast (Areas 1, 2, 3) – 739 awards
Southeast (Area 4) – 856 awards
West/DX (Areas 5, 6, 7, DX) – 596 awards
Central (Areas 8, 9, 10) – 722 awards

The exact regional boundaries are less important than the principle: aligning responsibility with workload rather than geography. Arguments can be made for other arrangements, but the net result will be:

• fewer award managers,
• reduced training demands,
• improved consistency,
• increased responsiveness, and
• enhanced communication in a tighter, purpose focused awards organization.

DX Area Alternative Structure

Although use of traditional mail services is declining, it is expected to persist as a delivery mechanism for award applications and certificates. U.S. postage to foreign countries is an increasing burden to the organization. This leads us to consider a synergistic possibility while pursuing the proposed restructuring.

Instead of combining the DX area with a non-homogeneous region, we could create a separate DX Region, which would be structured differently than other regions. In this modified scheme, the DX Regional Awards Manager’s function will not only include processing and approving award applications, but also printing and mailing award certificates to DX area residents, thus saving postage costs.

This alternate structure couples smaller award volume with a broader mix of tasks. The DX area would be somewhat more autonomous and self-contained.

Differentiating the DX Regional Awards Manager from the domestic managers suggests the need for a modified, elevated title reflecting the additional responsibilities, such as Assistant Awards Secretary and DX Coordinator.

This is just one idea that emerged while discussing this piece with one of our more engaged members. Intelligent discourse by the Board as they plan the reorganization will surely yield other synergies.

The Board needs to be open-minded and adaptable as they take on major policy updates. Thinking about related subjects like DX awards should be part of the discussion. Let’s continue with the framework for them to consider.

Concentrating Talent

Fielding four energetic and qualified Regional Awards Managers is a much less onerous process than attempting to fill eleven slots with whoever the Area Director can either conveniently plug in or, failing to do so, take on the responsibility themselves. The case for consolidation makes itself.

The current collection of awards managers displays a wide variance in experience and acuity, which complicates management. Area Directors exert little effort training them, so the burden falls on the Awards Secretary.

When the organization implements a regional award structure, it must abandon the current system in which awards managers report to Area Directors. In the next section, I’ll describe the redrawn lines of authority and responsibility necessary to support the awards system of the future.

A Novel Awards Subsystem

To reiterate, if Regional Awards Managers are responsible for multiple call areas, they must no longer report to Area Directors. A one-to-many relationship between operative function and the supervisor would cloud lines of authority and responsibility to the point of unmanageability.

Area Directors are policy makers, not operational functionaries. Furthermore, many Board members lack the necessary depth to directly supervise the awards system. Operational responsibilities should reside with those directly engaged in the function, under a clear and singular line of authority. Here, I propose a revamped organization chart to serve the needs of the organization in its second half-century.

Reporting Responsibilities

The Awards Secretary will be responsibility for hiring, firing, and day-to-day management of the newly created Regional Award Managers. This will greatly improve organizational consistency and communication efficiency. And, once again flagellating that necrotic equine, under no circumstances should area directors serve as award managers. Not now, not ever.

The existing system pays lip service to Area Awards Managers “working for” Area Directors. In practice, the system has evolved such that once “hired”, the Area Awards Manager has little contact with their Area Director.

Meanwhile, the Awards Secretary has daily contact with award managers, effectively acting as their supervisor. Yet when issues arise that require personnel changes or attitude adjustments, the Awards Secretary can only recommend appropriate action to the award manager’s Area Director, adding a layer of communication complexity and bureaucratic lag. In the new scheme, communication and day-to-day management are significantly streamlined.

As I mentioned previously, as Awards Secretary, I took responsibility for selection and vetting Area Award Managers—either when the area directors asked for help or when they failed to act and let a bad situation fester. I also regularly communicated with award managers and engaged in their day-to-day supervision. I resolved disputes between Area Awards Managers in different areas. This arrangement proved both natural and effective. Furthermore, many directors were happy to offload the work to me.

I am proposing that the organization formalize what has evolved into a responsive, albeit de facto, structure, further refining it by consolidating areas as described above. Supervising four, instead of eleven, awards managers, the Awards Secretary can optimize time and quality of supervision while enhancing system-wide communication.

“Charismatic leadership is one key to making beneficial changes in the system. Without it, external inputs are minimal, while internal churning consumes most available energy. The system produces more noise than signal and considers low-value output better than no output at all, especially when the required investment is correspondingly low.”

Reworking the Bylaws

The authority and responsibility of the Awards Secretary prescribed by the bylaws will require a major update. The position description will pivot from clerical toward managerial, aligning it with the unacknowledged current tacit responsibilities. The Awards Secretary is elected by the Board of Directors and serves at the pleasure of the President. Those organizational relationships and their inherent accountability will be preserved.

In the new structure, disputes over awards, formerly resolved by the Area Director, would first be brought to the Awards Committee, which would either settle the matter or refer it to the full Board of Directors if they could not.

These changes will create a responsive, efficient organization with a well distributed workload. Marginal “placeholder” volunteers will be boiled out of the system, while earnest, well qualified awards managers will remain. Thus, the awards system will be streamlined and competent.

Implementation Considerations

Such changes require sustained attention and coordination—qualities that volunteer boards often struggle to maintain. Updates to operating documents demand large infusions of energy for thoughtful consideration and decisive action. Late-stage organizations tend to mire themselves in minutiae, to the detriment of large-scale projects such as this one.

Charismatic leadership is one key to making beneficial changes in the system. Without it, external inputs are minimal, while internal churning consumes most available energy. The system produces more noise than signal and considers low-value output as better than no output at all, especially when the required investment is correspondingly low.

There is a chance that our entropic organization would view the project described here as an overly ambitious non-starter. Furthermore, a few Area Directors might dismiss it if they feel they are losing territory.

While this change alters the traditional role of Area Directors, it will also relieve them of the ongoing burden of recruiting and supervising Area Awards Managers—an obligation that has proven increasingly difficult to fulfill. Some might welcome the change.

The project described here is not a “one-and-done” motion. It will require enabling changes in documents, transitional accommodations, and careful implementation over a span of time much longer than a volunteer Board of Directors’ typical attention span.

Yes, it is ambitious, but it is certainly not unrealistic—especially if the Board can lay aside the minutiae to roll up its sleeves and collaborate on a major project.

What are the chances? History suggests they are not high—but neither is the probability of long-term success without change.

You can’t hit a home run if you never step up to the plate.

See my catalog of the entire Absurdist Papers Series by Vox Incommoda.

The post Absurdist 5: On Breaking from Tradition appeared first on The Nittany Turkey.

The Illusion of Process

“The question is not whether elections are held,
but whether they function.”

Elections continue to occur. Candidates are presented. Votes may even be cast. From the outside, the machinery appears intact.

The question is not whether elections are held, but whether they function.

My earlier opus, “When Participation Becomes Performative,” stated:

In healthy organizations, elections are noisy. Multiple candidates emerge organically. Outcomes are uncertain. Participation is visible and losing candidates still confer legitimacy by their presence alone.

In the subject organization, multiple-candidate elections are the outliers; single-candidate elections, including elections where placeholder candidates are chosen to comply with rules, are now the norm.

That earlier essay went on to state that at some point, the organization becomes self-referential, drawing only from those already inside the governance loop. Thus, elections cease to be aspirational. Participation becomes performative when outcomes are predictable.

Here, we examine what happens next.

The Single-Candidate Election

The bylaws prescribe a special election process to fill the crucial policy-making position. The current call for nominations yielded a single candidate in a mandated one-week period.

The candidate who emerged is a capable and concerned individual who currently serves as award manager in his area.

One candidate. No contest. No uncertainty. Given the predetermined outcome the election serves only to measure the level of residual engagement among the electorate.

The election will not select a leader. It will confirm the only available option.

From Selection to Ratification

In competitive elections, contrasting ideas are presented by a diverse collection of candidates. This leads to a selection process that advances the individual who best reflects the views of the electorate.

A single candidate offers no such choice. Thus, the election is not a selection process. It is a ratification mechanism.

When no alternative exists, voting becomes ceremonial.

Participation declines not from apathy, but from recognition that outcomes are invariant. Potential voters ask, “Why bother?”

The Shrinking Talent Pool

“As the pool contracts, roles do not remain vacant. They accumulate.”

I mentioned that the director candidate also holds the area award manager job. Whether he retains the dual role once he is established as a director will be clinically interesting.

If he does, he will be the third sitting area director who has appointed himself as award manager. We pointed out the perils of this duality in Absurdist 1.

It is no surprise that the one person who stepped forward was already in the system. With declining participation and a limited volunteer base, leadership will likely be drawn from the same internal cohort.

The issue is not lack of capable individuals, but lack of available and willing ones. The system increasingly selects from those already embedded within it.

When candidates are reluctant to commit themselves, participation must be actively encouraged among trusted individuals, frequently accompanied by a quiet minimization of the expectations attached to the role. Selection becomes solicitation.

We see the same familiar faces, serving in multiple roles.

The Deference Trap

“Respect for experience becomes a liability
when it suppresses participation.”

In some cases, multiple qualified individuals exist who could serve in leadership roles. Yet these individuals decline to run, not due to lack of capability, but out of deference to incumbent leadership.

The reasoning is straightforward: experienced leaders are respected and challenging them is seen as unnecessary or even inappropriate.

This reasoning assumes that stability in leadership is inherently beneficial and that continuity outweighs the value of competition. In system terms, this replaces a selection mechanism with a preservation mechanism.

The consequence of such deferential behavior is that qualified candidates select themselves out, incumbents remain unchallenged, elections become uncontested, and the leadership pool stagnates. When capable individuals decline to run, the absence of competition is not evidence of consensus. It is evidence of constraint.

A closed system does not need to exclude new participants; it only needs to provide no reason for them to enter.

Renewal vs. Continuity

Leadership roles benefit from renewal. Committee roles benefit from continuity.

The system functions best when new participants are introduced at the leadership level, while institutional memory is preserved in advisory and committee roles.

When the candidate pool narrows and incumbents are not challenged, roles begin to accumulate among the same individuals, further reducing opportunities for new participants to enter the system.

Respect for experience is essential. However, when deference suppresses participation, it ceases to be a virtue and becomes a constraint on renewal.

A system that protects incumbency more than it encourages participation will eventually have neither.

Role Convergence

“Redundancy is discussed, but consolidation is practiced.”

As the volunteer talent pool contracts, we can observe an increase in the number of individuals wearing multiple hats. I have already mentioned the possibility that after this election the organization will have three area directors who also serve as their area’s award manager. The associated confounding of lines of authority and responsibility was covered in Absurdist 1.

One current director is also the treasurer and the club’s membership coordinator. Other trusted, inner-circle directors and officers serve on multiple standing or ad hoc committees.

While the President and Board of Directors pay lip service to addressing single points of failure, there is little redundancy in staffing critical club functions. Lose one of these overloaded operators and the system is imperiled.

Thus, with the contraction of the pool, roles do not remain vacant. Instead, they accumulate. Single points of failure, previously identified, are not eliminated but reassigned.

The Closed-System Feedback Loop

Now, we can see that with declining participation and shrinking candidate pools leading to uncontested elections, leadership merely recycles internally while roles consolidate. Barriers to entry increase as the system turns inward, and participation declines even further. It is now a self-referential system selecting from and reinforcing itself.

The Consequence: Stability Without Renewal

The danger is not collapse. It is permanence without relevance.

The system indeed continues operating, giving the outward appearance of normalcy: running nets, issuing awards, holding meetings, and conducting events. But internally, adaptability is decreasing while entropy is steadily increasing.

The organizational body is ailing. The diagnostic interpretation is clear; the pattern is increasingly evident. Absent external intervention, the decline will continue.

In the meantime, hope for increased accountability and improved functionality rests in the general membership’s willingness to question organizational leadership. In self-referential systems lacking any significant internal feedback, external observation becomes the only corrective force.

The Question That Matters

If an election produces the same outcome regardless of participation, is it still an election? Or is it merely confirmation of the status quo?

The answer may depend on whether anyone is still watching.

See my catalog of the entire Absurdist Papers Series by Vox Incommoda.

The post Absurdist 4: On the Closed-Loop Election appeared first on The Nittany Turkey.

Eleven days after the April 11 board meeting, the minutes had not been posted. The bylaws require that minutes be prepared and published for Board and membership review within ten days. At 9:14 AM, I posted a simple inquiry to the club-wide discussion group asking whether the minutes were available. At 1:15 PM, the Secretary responded with an apology and posted them.

The sequence is instructive.

A time-bound, bylaws-mandated function went unfulfilled. Neither the President, the Vice President, nor any of eleven Area Directors took any action. Only after a member-at-large raised the issue did the process complete—within hours.

The Failure of Oversight

This was not a failure of capability. It was a failure of oversight.

The organization has recently shown a keen interest in imposing redundancy and administrative control over selected communication systems—most notably a long-standing discussion group that has operated without incident for decades (see Absurdist 1). Meanwhile, previously identified crucial single points of failure (see Absurdist 2) remain unresolved, perhaps even unnoticed. Most critically, a legally mandated corporate function—the preparation and publication of official minutes—remains dependent on a single individual, with no evident monitoring, escalation, or shared responsibility.

The contrast is difficult to ignore. Redundancy is demanded where it is unnecessary, and absent where it is essential.

Human Error and Institutional Responsibility

It would be easy to dismiss this as simple human error. People forget. Tasks slip. That is precisely why institutions establish process, accountability, and checks. In this case, those mechanisms were either absent or inactive. When the failure surfaced, it was corrected immediately, suggesting that the underlying system is fully capable of functioning when attention is applied.

A similar pattern appears outside the organization. In a recent warranty return with a major manufacturer, a replacement request remained in a static “processing” state for ten weeks. Only after direct inquiry did the case advance, with the explanation that escalation had not occurred because no prior contact had been made. Once prompted, the replacement shipped the same day.

In both cases, the system worked—once someone noticed.

Selective Fidelity in the Record

Even when processes execute and records are produced, they do not necessarily capture the substance of events. In the April meeting minutes, the IT Task Force provided a detailed report of activities and planned work. In contrast, the Awards Committee ‘report’ consisted of a routine listing of awards issued, offering no insight into committee activity.

More notably, a discussion concerning control of a long-standing communication system was summarized generically, omitting a directive introduced during the meeting that would impose new administrative requirements. That directive does not appear in the official record, nor is there evidence of Board affirmation.

The result is a record that is formally complete but substantively selective. Decisions and proposals that shape operational behavior may exist only in transient channels, while the permanent record reflects a narrower, sanitized version of events.

Awareness, or Lack Thereof

This pattern extends beyond delayed execution to the prioritization of communication itself. In a prior instance, a Board-approved change to member fees, designated for immediate publication, did not appear on the primary website channel for several weeks. During that period, other content was given prominence. The information was eventually published two months later, well outside the required timeframe.

The implication is not that decisions are not made, but that their communication is subject to discretionary prioritization, even when timing requirements are explicit. The limiting factor is not capability, but awareness. In the absence of external prompting, processes enter a steady state of inactivity while preserving the outward appearance of operation. In some circles, this is described less charitably. Here, we call it entropy.

This is governance by interruption. Not continuous oversight, not enforced procedure, but sporadic activation triggered by visibility. When no one looks, nothing happens.

In this system, a report need not describe activity; it need only resemble one.

The bylaws are not forgotten. They are simply inert until observed.

The next Absurdist Paper may return to performative elections—unless, of course, something more immediate presents itself.

See my catalog of the entire Absurdist Papers Series by Vox Incommoda.

The post Absurdist 3: On the Absence of Oversight appeared first on The Nittany Turkey.

Levothyroxine is consistently in the top 10 most prescribed medications in the United States. We’re talking 100-120+ million prescriptions annually. For a thyroid hormone, already!—as it turns out, a thyroid hormone most people don’t actually need replaced.

Recently, a study in the Netherlands found that many low-dose, long-term, borderline indication patients like me who had been taking levothyroxine for years could safely withdraw from the drug. Especially those older adults who were at very low doses were successful with deprescribing the synthetic hormone.

This raises the question: Why the hell am I still taking this crap and why have I been taking it for so damn many years?

With the collaboration of Dr. Macallan, I am suspending my daily 25 microgram dose of levothyroxine. We’ll do labs in six to eight weeks to assess whether I have any real thyroid issues. But I must wonder whether I ever did! Here, I will explore the sordid history of mainstream medicine and “thyroid pills”, followed by my expectations about life after levothyroxine.

First, though, I must state that I am not condemning levothyroxine, which is used to treat thyroid issues such as Hashimoto’s Disease, an autoimmune disorder affecting many women including my wife. Conditions such as this causing hypothyroidism do require lifelong treatment with carefully titrated and monitored dosage. The overprescription I refer to here is in connection with what came to be known as subclinical hypothyroidism—in other words, “You’re too fat, so you gotta take thyroid medicine.”

Back in the Day…

My family doctor prescribed Synthroid 25 mcg back in 1965, when I was a chunky teenager. I presented to him with a back issue, the earliest instance of a lifelong struggle with back pain. After a thorough examination, Dr. Citronella pronounced me overweight with high blood pressure, prescribing a “water pill” along with the levothyroxine.

That’s when the levothyroxine started. Yep, 60 years ago.

But I was a kid and by 1968, my priorities didn’t include refilling prescriptions every month. Early in my teen years, my Dear Old Dad had issued the edict: “When you’re 18, out of the house!” I took that literally; I got the hell out at 17. Thus on my own, managing my own health care with no nagging parents around, I did what kids do—assume immortality and ditch the pills. After all, they didn’t seem to do anything one way or the other.

I was living in Queens and working in Manhattan. In New York, you do lots of walking. I was still overweight, but I was in pretty decent shape, felt good, and had plenty of energy. So what the hell good were these little pills? I quickly forgot I ever took them, and I didn’t see a doctor again until I was in my late thirties.

Thyroid Hormone Fixes What Ails You

In the 1950s through 1970s, it was standard procedure to push thyroid hormones at patients describing various suspicious symptoms including fatigue, weight gain, dry skin, or having a pulse. Hell, everyone at the Moose lodge was “on thyroid”, so why not? That was the era of the vogue hypothyroidism diagnosis. Little testing was available to assess underlying issues, so the shotgun treatment was seen as good science. Burp!

Until levothyroxine was invented, desiccated thyroid extract, usually from pig thyroid, was the drug of choice.

Yes, patients would lose some weight initially due to an increase in metabolic rate. This would reinforce both patient and physician perceptions that the treatment was working. Now, empowered by their success, physicians skipped the testing and prescribed, prescribed, and prescribed.

Levothyroxine Worked, Didn’t It?

Sure it worked. Increasing thyroid hormone increases basal metabolic rate, increases lipolysis (“burning” fat), and increases sympathetic tone. People lost weight and felt more energetic—or maybe jittery, if they got too big a dose.

But while the weight loss was happening, they were also losing muscle, something I’ve dwelt on here in connection with GLP-1s or any other weight loss inducing drug. Bone loss, as well. And thyroid hormone can cause cardiac arrhythmia to boot.

Finally, dicking around with Mother Nature caused long-term metabolic disruption in many, many lifelong thyroid patients. For a lifetime.

There just ain’t no such thing as a free lunch.

What the medical geniuses of the time were doing was purposefully inducing mild hyperthyroidism and calling it treatment. Medieval medical elegance!

Habits Linger: The 1970s-1990s

Starting with the 1970s, we entered a new era of medical enlightenment where thyroid treatments became more scientific. Better testing, such as TSH assays, became available, along with better understanding of thyroid physiology. This should have fixed things—in theory.

However, in practice, doctors were still running on the old paradigm. Whereas medical research may advance quickly, clinical practice evolves at a snail’s pace. Protocol medicine has staying power even when guidelines change. In other words, old habits die hard. Doctors still had decades of “this seems to help” baked into their habits.

The hardening of thyroid science led to a new category: subclinical hypothyroidism. This assessment translates to, “Looking at your labs, I see your TSH is a slightly off-kilter, and you’re kind of thick around the middle, so let’s nudge your metabolism with some Synthroid.”

Back on Levothyroxine

And that is how I managed to get back on the stuff in the 1990s.

I started seeing the doc regularly again around 1984, after a gallbladder attack reminded me that I was no longer immortal. I was hospitalized for a week, during which I donated my infected component and its many gallstones to medical science—or the pathological trash bin, as it were.

As my weight crept up in the 1990s, it was inevitable that I would be diagnosed with subclinical hypothyroidism and be dosed with the magical substance, again at the minimum dose. And I’ve been taking it ever since.

From Myth to Dogma: the 1990s-2010s

I stopped thinking about it. I just took it. The little orange pill was just a part of my everyday routine. No questions asked.

Once in a while, a doctor who noticed I was taking levothyroxine tested my TSH and maybe T4, then glanced at the results, grunted, and moved on. Nothing to see there, so lets just preserve the status quo.

Was levothyroxine working? Who da hell knows?

Whether doctors feared rebound effects or just resisted deprescribing so-called lifelong prescriptions, no one ever gave it a second thought. Like many others, I was on low-dose levothyroxine for life. I guess they thought it was like metabolic chicken soup—it might not fix anything, but it couldn’t hurt!

Levothyroxine in 2026

The Netherlands study I mentioned at the outset revealed that treating mild or subclinical hypothyroidism often does not improve symptoms, does not reduce weight, and does not improve quality of life. Furthermore, in older adults, overtreatment risks atrial fibrillation, bone loss, and mortality signals in some cohorts.

The disturbing conclusion: A non-trivial number of people have been on levothyroxine for years—for no compelling reason.

They might have been “fat and tired” at one point. Seeing the doctor led to the great “must be your thyroid” boondoggle. And so it went.

Some Encouraging Observations

Metabolic ironies abound.

Thyroid hormone supplementation increases gluconeogenesis. In plain English, it can raise blood sugar, which isn’t a good thing for a diabetic like this Turkey. If you remove it, the glucose decreases.

My HbA1c has been in the 5.3-5.5% range for over a year now, with fasting glucose in the high 90s or low 100s. My insulin levels are reasonable. So, I’m not a metabolic disaster awaiting rescue. Plus, my aversion to polypharmacy impells me to discontinue drugs if they’re not doing me any good or worse, doing me harm.

Since discontinuing the levothyroxine, I have noticed a small, but perceptible, downward shift in my baseline blood glucose, along with muted peaks. While this is non-scientific, preliminary, anecdotal bullshit, it hints at an unexpected benefit of deprescribing levothyroxine.

Approaching 80, actionable epiphanies are rare. This one hit me squarely between the eyes, and I jumped on it.

Da Bottom Line

Thyroid hormone earned a long, slightly disreputable career as a weight nudge, a fatigue placebo, and a “something must be wrong” prescription. For many patients, including me, it might have been initiated on shaky grounds, continued by inertia, and now only questioned because I finally had the audacity to read the literature instead of just stupidly swallowing the pill.

Medicine loves a good habit. Breaking one requires data and a somewhat stubborn patient.

While it is unfortunate that many doctors just reflexively prescribe drugs, patients can help themselves out of “one-size-fits-all” treatment. Do not be reticent about questioning protocol-driven medicine. Knowledge is power.

Peptide Purgatory is a regular feature of this blog. For an annotated catalog of all my Mounjaro, GLP-1, and Peptide Purgatory updates, please visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: Thyroid Myths and Modern Medicine appeared first on The Nittany Turkey.

Organizations create rules to constrain behavior. Adoption by the governing body is accompanied by a tacit commitment to enforcement, for without enforcement, rules are signaling, not governance.

Absurdist Paper Number 2 presents a particularly flagrant example of non-governance in which the organization’s board of directors unanimously passed a bylaws update in February of 2024 but refused to act on it in November of the same year.

My intent here is not to assassinate the character of individual officers and directors, but to hold the organization collectively responsible for its failure. I’ll name no names. All are complicit.

The Rule

The subject rule was part of a sweeping bylaws update passed by a 13-0 vote of the full board in February 2024. The Bylaws Committee had rewritten Articles I (Board of Directors) and II (Officers, Volunteers Positions, and Standing Committees) in their entirety, providing the full text to the board well in advance of the meeting.

This Absurdist Paper focuses on one provision concerning abandonment of a director’s position:

Abandonment. In the event an Area Director fails to have his or her area
represented for three of the five prior consecutive months at the regularly scheduled
BoD meetings, the President must notify the Chair, who must present a motion at the
next scheduled BoD meeting to declare the Area Director position vacant. To pass,
the motion requires a majority vote of the eleven Area Directors then in office.

Here, it is interesting to note that the director who would ultimately be the subject of the first enforcement test of this rule cast an affirmative vote to approve the measure.

The Trigger Event

In November of the same year, owing to habitual absences that left a particular director’s area completely unrepresented, the organization’s president found himself in the uncomfortable position of needing to comply with the abandonment rule. He wrote a motion for removal of the affected director, which he routed through the chair to the board of directors for approval.

The case for abandonment was unambiguous. The director had not only completely left his area unrepresented for the requisite three out of five meetings, but also had been a habitual offender. In fact, over the previous two years, in seven five-month periods, he was absent from three of five. To further compound the malfeasance, in four of those periods he was actually absent for four out of five meetings.

Up to this point, the system, designed as a safeguard against abandoning representation for area members, was working properly. However, as you will see, that changed dramatically when the question was called at the board meeting.

The Pivot: From Rules to Feelings

The waffling started almost immediately when the chair read the motion and called for a discussion before the vote.

The general sentiment among the board was that the director was a friend, a nice guy who travels frequently, and maybe his life outside the organization was getting in the way. They felt they should be more compassionate and understanding.

The director charged with abandonment gave them assurances that he would do better in the future, and wanted “another chance.”

The discussion did not center on whether the director violated the bylaws. It centered on whether the bylaws should matter in this instance.

Meanwhile, other directors were talking about “grace,” despite the bylaws structure.

One director attempted to ground the discussion in reality when he noted that the bylaws update had only recently passed. It was designed to ensure board members attend meetings.

That was met with a “yes, but…” response from another director who opined that the bylaws are a “living document” that should be adjusted as times change.

Another director said that nothing in the bylaws prevented calling the director to give him a friendly reminder that he needed to show up for meetings.

And so it went.

The discussion did not center on whether the director violated the bylaws. It centered on whether the bylaws should matter in this instance.

The Smoking Gun: They Knew Better

After this robust discussion, one director felt the motion should be tabled for further consideration. The motion to table overwhelmingly failed.

The directors present thus expressed the desire to vote on the motion then and there.

First, the Bylaws Committee chair, also a director, noted that laws in the state of incorporation require that this vote be restricted to directors (which means the president and vice president do not vote).

Then, the board chairman called the question.

Only three out of eleven directors approved the motion to declare the position abandoned. Of the remaining eight, five disapproved and three abstained.

Abstentions? In a situation that boils down to “guilty” or “not guilty,” there are no maybes. Why, then, would a responsible director abstain?

Abstentions in a binary enforcement decision vote represent a refusal to decide. For a director voting on an important organizational issue, this amounts to shirking one’s obligation to the members.

I previously touched on one director’s assertion that the bylaws were plainly stated and this case was a clear-cut violation of them. The path forward was spelled out. Indeed, that director was part of the minuscule minority who voted in favor of removal.

The Bylaws Committee chair, also a director, was present to answer questions. He also was a minority “yes” vote.

One other director chose the responsible path.

The majority, whether through “no” votes or abstentions, chose not to act.

The Structural Failure

Failure to act on an obvious breach of rules because the consequences as provided in the rules appear to be too harsh does not signify compassion, flexibility, or nuance. It reduces to selective enforcement of formal rules.

As we mentioned in Absurdist 1, where handwringing over management of a simple discussion group took center stage, the organization wants to impose rigid controls over trivial systems while optionally enforcing rules for critical systems.

The Real System

This inability to tackle difficult issues — avoiding friction — is characteristic of late-stage organizational entropy. The focus is on having fun while existential problems go unresolved.

The system is not optimized for compliance, governance, or accountability. Instead, the system is all about:

• avoidance of interpersonal conflict,
• preservation of relationships, and
• minimizing discomfort in the room.

The priority becomes concluding the meeting, not resolving the issue.

Rules exist until they become inconvenient. At that point, they are subjected to interpretation, mitigation, deferral, and finally, they might be completely ignored.

The Consequence

The bylaws are rendered advisory rather than binding. Governance is illusory.

This organization has demonstrated repeatedly that its rules are there to be broken. The bylaws are not binding. Only advisory.

Only nine months were required to test the abandonment rule. That test produced hesitation, reinterpretation, and ultimately, non-enforcement.

Although this is one example of what has become a habitual occurrence in this organization, you need but one such event to establish precedent.

In Closing

Governance did not fail when the rule was written It failed when it was first ignored.

In Absurdist 1, we highlighted organizational paranoia over discussion group redundancy. In Absurdist 2, we spotlight indifference to governance failure.

Same board, different risk tolerance.

Entropy is no longer theoretical. It is observable.

See my catalog of the entire Absurdist Papers Series by Vox Incommoda.

The post Absurdist 2: On The Illusion of Governance appeared first on The Nittany Turkey.

Absurdist Paper Number One considers two systems. The first is a working communication channel that management feels needs tweaking even though it has functioned well for a quarter century. The second is a dysfunctional management problem that is far more dangerous to the organization, but is conveniently ignored. The former needs no solution, because it functions as it always has, while the latter begs for one. The system chooses solvable but low-value problems over meaningful but uncomfortable ones.

Much Ado over Solving A Non-Problem

The communication channel in question is a member-run discussion group where the organization’s members can discuss matters of concern. It has been administered by the same individual member for twenty-five years. Call it Group A. At some point long in the past, a disgruntled member created a second group, Group B, presumably due to a few members’ animosity toward the administrator of Group A. Now, suddenly, although Group A has three times the number of subscribers as Group B, management has decided that the latter will be the official channel.

Such groups are typically administered by an individual member. Any essence of organizational ownership is an illusion.

Group B was formerly managed by a member who did a significant amount of work for the club. Group A is managed by another long-time member who has served many roles in the organization. The difference? The administrator of Group B was held in favor by the current president, whereas the administrator of Group A is not. Following the death of Group B’s administrator, the president took direct control over the group, representing it as “club owned”.

Why Is This Needed?

This sequence of events, coupled with the obvious popularity of Group A, suggests an effort to displace the member not in favor. The president felt it necessary to demand that its administrator/owner turn his group over to the organization. Predictably, he refused. The fall-back position now being advanced by the president, without formal concurrence by the board of directors, is that all communication vehicles in the organization must have two administrators, so there are no single points of failure.

The ultimate irony is that the organization is furrowing its brow over what might happen in the event of a catastrophic failure of the Group A despite having made a seamless transition on the death of the Group B administrator.

Inconsistencies Abound

Paradoxically, this selective edict concentrates on easily corrected system faults while turning a blind eye toward significantly more consequential single points of failure. Before covering the most egregious of these, I must point to the organization’s house organ, a communication vehicle with a singular editor/publisher appointed by the same president who now demands bilateral authority over communication vehicles. Additionally, the organization’s website, obviously a communication vehicle, is similarly controlled, operated, and partially hosted by a single member. But these two members are trusted members of the president’s inner circle whereas the group administrator in question is not.

The organization is thus missing the point by:

• over-engineering trivial systems,
• arbitrarily exempting comparable systems, and
• ignoring critical systems

Ignoring a Critical Single Point of Failure

The most blatant example of a potentially harmful single point of failure is in allowing the same person to function as an area director and area award manager. That subsystem, if faulted, could cause significant pain. And this organization has not just one, but two such situations. Others have existed in the past.

Even without complete failure, this duality of roles is problematical. The award manager answers to the area director. As they are the same person, accountability is nonexistent.

“The organization is proposing structural safeguards against failure in a non-critical system, while leaving a known single point of failure unaddressed in a critical one.”

That such failure modes might exist is not purely theoretical. One of the dual-role directors has been charged with abandoning his position, but those charges were dropped. This same director has delayed processing awards for significant stretches, which the organization does not tolerate elsewhere. Ordinarily, the president and the board would press the director to replace his or her itinerant award manager. But when they are the same person, especially when the board of directors refuses to hold the director accountable for non-compliance with the bylaws, there is no salvation.

Further Overcomplicating a Non-Issue

An additional absurdity arose when the president asked the membership committee to study alternative communication paradigms to replace the discussion groups. But no one is complaining about the discussion groups. They do their job. This raises the question of whether the organization is attempting to redesign a system that is not demonstrably broken.

“… information without implementation is noise—in a system where signal-to-noise ratio is already minuscule.”

Gathering information about more sophisticated replacement systems such as Slack and Discord is a significant waste of organizational resources. Implementing these overkill solutions would come at a cost in man-hours and members’ learning curves. Once these impediments are recognized, implementation will be doomed. What will remain is a compendium of information that will never be used. And information without implementation is noise—in a system where the signal-to-noise ratio is already minuscule.

Sound Management Principles?

Setting aside this extravagant mission expansion, the proposed new duality policy is ostensibly concerned with implementing a sound organizational framework. Beneath the surface, it appears to be something different.

The discussion group problem is trivial. If an administrator leaves, another can assume the role. Even in the worst case, the system can be reconstituted with minimal disruption, as was borne out by the seamless transition after the death of Group B’s administrator.

On the other hand, the area director/award manager problem can be devastating, whether from abandonment or simply malfeasance. Membership goodwill is at stake when awards are interrupted, and especially when initial awards (which confer membership) are delayed inordinately. But solving this problem involves confrontation, political maneuvering, bylaws changes, and personal feelings, all of which are roadblocks in an organization that cannot face its deficiencies.

Thus, the organization is proposing structural safeguards against failure in a non-critical system, while leaving a known single point of failure unaddressed in a critical one.

Path Forward: From the Ridiculous to the Sublime?

Instead of prioritizing the discussion group issue, the organization should concentrate its scarce management resources on solving the much more onerous potential single point of failure. Amend bylaws to require separate individuals for area directors and award managers while maintaining stringent standards of conduct by directors, as provided in the current bylaws.

The organizational obsession with concentrating energy on solutions in search of a problem is a disciplined effort to optimize irrelevance.

See my catalog of the entire Absurdist Papers Series by Vox Incommoda.

The post Absurdist 1: On the Selective Elimination of Single Points of Failure appeared first on The Nittany Turkey.

Vox Incommoda — the inconvenient voice.

Under this name, I will publish a series of essays examining the mismanagement of an organization with which I have intimate familiarity. No individuals will be singled out; the focus is not on personalities, but on patterns. The essays are titled The Absurdist Papers.

This organization’s decline has been discussed here before, largely abstractly, from a systems perspective. These papers will shift the lens to the operational level, analyzing specific decisions, policies, and behaviors. Taken together, they constitute a case study in late-stage organizational entropy.

Each paper will address a specific management issue and will be numbered for easy reference by future historians. Publication will be periodic, dictated less by schedule than by opportunity. Management, in its natural state, rarely disappoints.

If the perspective proves uncomfortable, it is likely working as intended. The voice is inconvenient by design.

Following is a catalog of all essays in this series.

• The Absurdist Papers 3 weeks ago
  Vox Incommoda, a pseudonym meaning the inconvenient voice, introduces The Absurdist Papers, a series of essays examining the mismanagement of an organization with which the author is intimately familiar.
• Absurdist 1: On the Selective Elimination of Single Points of Failure 3 weeks ago
  Systems often eliminate redundancy risks where failure is merely inconvenient, while tolerating them where failure is consequential.
• Absurdist 2: On The Illusion of Governance 3 weeks ago
  A rule unanimously adopted becomes meaningless when the same body refuses to enforce it at first contact with reality.
• Absurdist 3: On the Absence of Oversight 2 weeks ago
  Our subject organization provides more fuel for my essayist’s pleasure, displaying a lack of governance oversight ranging from mild disinterest to complete apathy. Increasing entropy in action!
• Absurdist 4: On the Closed-Loop Election 2 weeks ago
  If a single-candidate election produces the same outcome regardless of participation, is it still an election?
• Absurdist 5: On Breaking from Tradition 1 week ago
  Our subject organization has been in existence for fifty years but has clung to traditional structure and methods despite changing conditions.

The post The Absurdist Papers appeared first on The Nittany Turkey.

After having some fun bashing this research, I’ll update you on my personal progress, which was interrupted by an unplanned trip for the funeral of a dear friend.

So, lean back, grab your pencils, and keep them firmly in your grasp. You’re about to learn… not much.

GLP-1s, Erectile Dysfunction, and the Fragile Male Operating System

Somewhere between the miracle of GLP-1 receptor agonists and the quiet disappearance of your third helping of mashed potatoes, a new panic has emerged:

“Wait… are these drugs messing with my… signal integrity?”

Nothing terrifies a certain demographic quite like the possibility that metabolic optimization might come at the cost of… let’s call it peripheral performance degradation.

So naturally, the headlines have arrived right on schedule.

A recent real-world study suggests that men with type 2 diabetes on GLP-1 drugs may have a modestly higher rate of erectile dysfunction compared to those on DPP-4 inhibitors.

Cue the collective clutching of pearls.

Let’s Translate This Like Adults

First, the numbers.

• ED is already present in about 50% of men with type 2 diabetes.
• The study found about a 26% relative increase in diagnosed ED in GLP-1 users.

Relative increase. Not absolute. Not “your love life just got unplugged.”

If your baseline risk is already coin-flip territory, a relative bump is statistically interesting but clinically… murky. Even the authors basically said: “Yeah, this might be real… or it might be bias, confounding, or the statistical equivalent of a loose wire.”

Translation: don’t sell your Cialis stock just yet.

The Irony Is Almost Too Good

GLP-1s:

• Improve glycemic control
• Reduce weight
• Improve endothelial function (in many contexts)
• Lower cardiovascular risk

And what is erectile function, fundamentally? A vascular event with a software component. So in theory, these drugs should help, not hurt.

In fact, some prior data suggest exactly that. So why the discrepancy?

Possible Explanations (Pick Your Favorite)

Detection Bias: Men losing weight and re-entering society may suddenly notice problems they previously ignored. Nothing like renewed ambition to expose old hardware limitations.

Confounding by Indication: GLP-1 users often start off:

• heavier
• more metabolically deranged
• possibly further along the vascular damage curve.

Rapid Weight Loss Effects: Hormonal shifts, transient energy deficits, and adaptation phases can temporarily mess with libido and performance.

Psychological Variables: Nothing kills the mood like obsessing over whether your medication is killing the mood.

The Real Takeaway (Brace Yourself, It’s Boring)

GLP-1s are not stealth anti-erection agents deployed by Big Pharma to reduce the birth rate.

What you’re seeing is:

• noisy real-world data
• layered on top of a condition (diabetes) that already wrecks vascular and neural function

And the signal-to-noise ratio is… let’s be charitable… suboptimal.

Meanwhile, in the Real World

If a drug:

• lowers your A1C
• trims visceral fat
• improves cardiovascular outcomes

…then it is almost certainly doing more for your long-term function than against it.

Because the alternative path, untreated metabolic syndrome, is basically a slow-motion denial-of-service attack on every vascular bed you own.

Enter the Compounding Industrial Complex

Of course, no good medical ambiguity goes unmonetized. Give this about fifteen minutes, and one of our more agile telehealth startups will connect the dots with the enthusiasm of a toddler holding a Sharpie. I predicted this marketing coup in a post nine months ago.

You can practically see the landing page already:

“Optimize Your Metabolism and Your Performance”
One convenient vial. One discreet shipment. One slightly uncomfortable conversation avoided forever.

After all, these are the same folks who built an entire business model on the back of phosphodiesterase inhibitors and male insecurity. Pivoting from “boner pills” to “boner pills plus metabolic optimization” is not exactly a moonshot. It’s a lateral move with better margins.

So why stop at plain old tirzepatide?

Why not:

• Tirzepatide + sildenafil
• Pre-mixed, pre-branded, pre-justified
• Marketed as “synergistic therapy” instead of what it actually is: pharmacologic duct tape

Never mind that:

• One drug modulates incretin signaling and glucose homeostasis
• The other tweaks nitric oxide pathways downstream

Totally different systems, loosely connected only by the fact that both ultimately rely on intact vasculature and a patient who hasn’t completely fried his endothelium over 30 years.

But nuance doesn’t sell. Convenience sells. Embarrassment avoidance sells. Monthly subscriptions sell.

The Inevitable Pitch

Expect language like:

• “Comprehensive men’s metabolic vitality protocol”
• “Dual-pathway optimization”
• “Clinically inspired combination therapy”

Translation:
“We noticed two things men worry about and decided to ship them together.”

Let’s capitalize on men’s sexual insecurity.

The Punchline

And here’s the part that would be funny if it weren’t so predictable:

The same patient who:

• ignored diet for decades
• treated exercise like a rumor
• and let insulin resistance run a quiet insurgency

…will now be offered a neatly packaged biochemical workaround for both the cause and the consequence.

All in one vial.

Because nothing says modern medicine like solving a systems problem with a bundled SKU from a mail-order pharmacy with a handy telehealth doc to rubber-stamp your prescription.

Final Thought for the Concerned Gentleman

If you’re worried GLP-1s are sabotaging your performance, consider the baseline: diabetes itself is the original saboteur. It doesn’t just dim the lights, it cuts the wiring.

Blaming GLP-1s for ED is a bit like blaming the electrician for discovering your house was already on fire.

My Progress on Mounjaro

Much time has elapsed since I wrote the last periodic update of my progress on Mounjaro (tirzepatide), the GLP-1 RA drug I’ve been injecting in my deflating belly since June 2024. I remain at the 7.5 mg dose, half the maximum. It has done a good job reducing my HbA1c to 5.5% and I’ve lost about 70 lbs.

My current weight is stable at around 175 lbs. Based on DEXAscan and RMR results I have previously reported here, I would like to be at 169, and I’m engineering my nutritional intake to get me there. Slowly.

As I approach my 80th birthday, I recognize that too rapid weight loss carries with it the danger of increased muscle loss which exacerbates the natural aging phenomenon known as sarcopenia. Thus, I established a stringent physical training program to build muscle. Cardio is not enough — old farts like me are hereby advised that resistance training to maintain muscle functionality is non-negotiable.

My glucose is up a bit, with this past week’s average sitting at 117, which sucks. This correlates with suspension of my training program coupled with a poor diet for two weeks while I drove to Pennsylvania and back for a funeral. All the exercising I could arrange was five minutes daily ascending and descending twelve flights of stairs. Minimal cardio.

And, of course, road food at Buc-ee’s is not exactly a low-carb, high-protein diet.

I’ve now shaken the travel weariness, and my home gym awaits a full Saturday workout. My diet is back to normal, with concentration on getting 120-140g of protein daily and limiting carbs to 160g or so. On Monday, I’ll return to the YMCA, where I do my cardio and some strength machines.

Back on track.

See you next week, or even sooner.

For an annotated catalog of all my Mounjaro updates, please visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: GLP-1 Saltpeter? appeared first on The Nittany Turkey.

Back in early January, I returned a disk drive to Western Digital for warranty replacement. I sent it via UPS 3-Day, which—at least in the real world—means three days. Western Digital, however, appears to operate in a different space time continuum, because they claim to have received it on January 29, roughly two-and-a-half weeks later. Perhaps the package took a scenic route. Maybe it stopped for barbecue in Memphis. Who the hell knows?

Fast forward to today. Having not received a replacement, I checked their website again. The status reads “Received / Processing,” which is exactly what it has said since the day they finally acknowledged possession of the drive.

Ten weeks.

Ten weeks of “Received / Processing.”

At this point, I would accept almost any variation. “Approved / Shipping” would be nice. Even “Processing / When We Get Around To It” would at least demonstrate a refreshing commitment to honesty. But no. Western Digital has achieved a kind of Zen minimalism in customer communication: one phrase, endlessly repeated.

Eventually, I decided to engage with their customer support apparatus, which is engineered with all the warmth and accessibility of a nuclear launch console. After navigating the usual menu gauntlet—language selection, status inquiry prompts, and other opportunities to talk to a machine that would inevitably tell me “Received / Processing”—I chose Option 4: speak with a human being.

This was a bold move.

Ethan of Hyderabad

Hold music confirmed my decision. There was no estimate of wait time, which is always reassuring. After a few minutes, accompanied by a series of clicks and noises suggesting either a connection or the early stages of system failure, a rather Indian sounding human voice emerged.

“This is Ethan speaking. May I have your name and your support number?”

“Support number,” it turns out, meant the RMA number. We established that successfully, which already put us ahead of many such interactions.

I explained that the drive had been received on January 29 and that the status page had remained unchanged ever since.

“May I put you on hold for a brief moment?” Ethan asked, with the kind of politeness that suggests he was about to consult either a database or a Ouija board.

“Sure,” I said.

More clicks. More silence. Then Ethan returned, apologizing for the delay and delivering the key insight:

“The reason your case has not been escalated is because you have not called us previously.”

There it was. The missing piece of the puzzle. Western Digital’s system apparently assumes that if you haven’t called to complain, then everything is proceeding perfectly. Ten weeks of inactivity? Clearly, the customer is thrilled.

Ethan assured me that now—now that I had called—the case would be escalated, and the RMA team would provide a tracking number once the replacement shipped.

In My Lifetime, Please

I responded, perhaps optimistically, “I’d like to receive the replacement drive within a human lifespan. If the exact part is out of stock, I authorize substitution with an upgraded model.”

Ethan, reading from what I can only assume is a script forged in the fires of corporate risk management, glossed over my sarcasm when he replied that the RMA team would send the replacement within my specified time frame and would provide a tracking number when it shipped. If I did not receive it, I was encouraged to call back, provide the same RMA number, and speak with another representative “who will be able to help.”

One can only admire that level of confidence in the next guy.

At that point, I decided to stop pressing my luck. I told Ethan that if Western Digital simply sent the replacement drive, I would consider the matter resolved and would not trouble them further.

After all, it was 2:00 AM in Hyderabad, and somewhere on the other end of the world, a support agent had just successfully escalated my problem from “ignored” to “acknowledged.”

Progress, in its own way.

Epilogue: Instant Action?

This morning, I received an email from Western Digital:

As it turns out, Western Digital’s warranty process works flawlessly, provided one critical condition is met: the customer must first call and remind them that the transaction is, in fact, real. Once that requirement is satisfied, events proceed with astonishing efficiency. In my case, the replacement shipped the very same day the case was “escalated,” strongly suggesting that the limiting factor in the system is not inventory, logistics, or engineering—but rather, attention.

And Then…

Two days after my call, I received a tracking number, confirming that the replacement drive had finally entered the shipping pipeline. This raises an interesting operational question: was the delay due to supply constraints, logistics complexity, or a simple lack of awareness that the request still existed? Based on the immediate response to escalation, one is left to conclude that Western Digital’s RMA process is less a pipeline and more a queue that requires periodic prodding to prevent it from becoming archival.

The post A Conversation with Customer Service appeared first on The Nittany Turkey.

Pharmaceuticals in vials bearing names like “Glow Stack” and “Wolverine Stack” are delivered in a nice, injectable form. Just grab a supply of needles and shoot up!

Why are they called “Stack?” What are they stacking—aside from Yankee dollars? And what is RFK Jr. smoking?

Anyhow, the guy who never met a plaintiff attorney he didn’t like and would prefer that our kids go unvaccinated considers himself a “big fan” of these alternative therapies. He promised to end the “war on peptides” and wants to make these gray market peptides legal and easier to buy. No doubt, a whole slew of “influencers” are champing at the bit awaiting kickback deals from the PRC.

Now, they have a new believer—our main man in HHS, RFK, Jr.

And this, my Turkey readers, is the topic of today’s BULLSHIT CORNER!

Peptide Purgatory, published whenever I feel like writing, mixes one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia. Ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: RFK Jr. Wants More Vogue Peptide Crap appeared first on The Nittany Turkey.

Readers with COPD should not read my emphasis on exercise as a scolding. Breathlessness is a real constraint, not a character flaw. Still, COPD and inactivity are a nasty combination because they accelerate muscle loss and make ordinary tasks harder. The answer is not necessarily “work harder.” Often it is “start smaller, but start deliberately,” ideally through pulmonary rehabilitation or a capability-appropriate strength routine.

So, Steve, this Bud’s for you.

GLP-1s and COPD

GLP-1s may help some COPD patients indirectly through weight loss, better diabetes control, and perhaps even fewer respiratory complications, but they are not a substitute for preserving muscle and function. In COPD, exercise need not mean heroic workouts. It may mean pulmonary rehab, chair-based resistance work, short walking intervals, or anything else that safely interrupts the vicious cycle of breathlessness, inactivity, and muscle loss.

My assertion that “everyone should seriously resistance train” is a generalization, a logical fallacy because everyone cannot sling heavy weights around like the guys at Gold’s Gym. So, please forgive the hyperbole. I will soften that to say that everyone should preserve function at the highest level they can safely sustain.

With COPD, success might mean standing up without assistance, walking a bit farther this month than last, or tolerating slightly more activity without panic-level dyspnea. Resistance work can be scaled to suit the body’s capabilities; nevertheless, regular resistance work is essential to combat loss of muscle and mobility.

Thoughts about Longevity with Type 2 Diabetes and COPD

For a 70-year-old male managing the “triple challenge” of Type 2 diabetes (T2D), obesity, and COPD, the introduction of a GLP-1 receptor agonist (such as semaglutide or tirzepatide) is often a clinical turning point. These medications are revolutionary for glucose control and weight loss, yet they come with a significant “biological tax”: muscle mass loss.

Recent research (circa 2025-2026) indicates that while GLP-1s are highly effective, a meaningful portion of the weight lost can be lean muscle and bone density rather than fat, especially in the absence of resistance training and adequate protein. For a senior, this increases the risk of sarcopenia—the age-related loss of muscle—which can lead to frailty, falls, and decreased metabolic health.

To maximize the benefits of your medication and ensure long-term mobility, a comprehensive self-care program focused on resistance exercise and nutritional support is essential.

Muscle Preservation

Your goal is not just to weigh less, but to function better. Muscle is the organ of longevity; it acts as a primary vehicle for glucose disposal, helping your diabetes, and it provides the structural support needed for a body navigating the respiratory constraints of COPD.

Studies published in the Annals of Internal Medicine (2025) emphasize that older adults on GLP-1s must engage in “structured movement” to prevent the functional decline that often follows weight loss.

(The now infamous medical gaslighter, Dr. DeLorean, once blurted out to me, “There is no evidence that GLP-1s cause muscle loss!” Well, schmuck, correlation is not causation, but there sure as hell is evidence confirming muscle loss during rapid weight loss. And GLP-1s cause rapid weight loss.)

Resistance Exercise First

I’m not going to pretend to be an exercise physiologist, a pulmonologist, or an endocrinologist. What I write below is what I have gleaned from reading various sources, which no doubt have flaws. Yet the general principles are sound for all of us, with the caution to check with your healthcare team first before starting any serious exercise program.

For a senior with COPD, the focus should be on functional hypertrophy: building muscle that helps you do daily tasks.

Exercising 2-3 20-30 minute sessions per week on non-consecutive days is reasonable, if you can tolerate it. Any strength exercise you do should involve enough resistance that the last two repetitions of a set of 10-12 feel challenging but achievable. Exercises can be with body weight, resistance bands, or weights.

Sample Routine

COPD Specific Tip: The “Exhale on Exertion” Rule People with COPD often hold their breath during exertion, which increases thoracic pressure. Always exhale during the hardest part of the lift (e.g., when pushing up from the chair) and inhale on the return. Use pursed-lip breathing (inhale through the nose, exhale through puckered lips) to keep airways open longer.

Nutritional Foundations: The Protein Anchor

GLP-1 medications significantly reduce appetite, which makes it easy to accidentally under-consume protein. Without enough protein, the body will “cannibalize” its own muscle to meet its amino acid needs.

• Protein Target: Aim for 1.2 to 1.5 grams of protein per kilogram of body weight.
• The “Protein First” Rule: Because your appetite is smaller, always eat your protein source (eggs, lean poultry, Greek yogurt, or fish) first before filling up on vegetables or starches.
• Timing: Distribute protein evenly. Aim for at least 25–30g of protein at each meal to maximize Muscle Protein Synthesis (MPS).

Manage the Type 2 Diabetes/COPD Intersection

Combining weight loss drugs with exercise requires careful monitoring of your specific health markers:

• Don’t Pass Out: GLP-1s rarely cause hypoglycemia on their own, but if you are also on insulin or sulfonylureas, the combination of medication and exercise can drop your sugars. Check your levels before and after your workout.
• Don’t Desaturate: For COPD management, keep a pulse oximeter handy. If your oxygen saturation drops below 88–90% during exercise, pause and practice recovery breathing.
• Don’t Dry Out: GLP-1s can affect your thirst signals. Dehydration can thicken mucus in COPD patients, making breathing harder. Aim for consistent water intake throughout the day.

Look Beyond the Scale

In this phase of life, the scale is a “noisy” metric. Instead, track your progress using functional milestones:

1. Grip Strength: Can you open jars more easily?
2. Stair Climbing: Can you climb a flight of stairs with less breathlessness?
3. Balance: Are you feeling steadier on uneven ground?

Summary of Daily Self-Care

• Morning: High-protein breakfast (e.g., cottage cheese or eggs); check blood sugar.
• Mid-Day: Short walk or a resistance session using pursed-lip breathing.
• Evening: Protein-forward dinner; track any GI side effects from the medication.

Wrapping It Up and Tying A Bow on It

What this all comes down to is not perfection, and certainly not heroics. If you are managing Type 2 diabetes, COPD, or both, you are already operating under constraints that younger, healthier people never have to think about. That is reality, not failure.

GLP-1 therapy can be a powerful tool. It can improve glucose control, reduce weight, and in some cases even ease the overall burden on your system. But it does not replace the basic physics of the human body. Muscle that is not used will be lost. Function that is not maintained will decline. The good news is that this process is not all-or-nothing. Even modest, consistent effort—scaled to what you can safely tolerate—can preserve strength, mobility, and independence far better than doing nothing.

Success, in this context, is not measured by how much weight you can lift or how closely you resemble a fitness model. It is measured by whether you can move a little better, breathe a little easier, and maintain control over your daily life. If that means chair-based exercises, short walks, resistance bands, or a structured pulmonary rehabilitation program, then that is exactly the right approach.

None of this should be done in isolation. The intersection of GLP-1 therapy, diabetes management, and COPD is complex enough that it deserves coordination. Your physician, pulmonologist, or rehabilitation team can help tailor a plan that balances benefit with safety—monitoring glucose, oxygen levels, medication interactions, and your individual tolerance for activity.

The objective is straightforward, even if the path is not: use every available tool—medication, nutrition, and appropriately scaled movement—to preserve function for as long as possible. You may not control every variable, but you can influence the trajectory. And in this setting, maintaining capability is not just a clinical goal. It is the difference between dependence and independence.

That is a goal worth pursuing, at whatever pace your lungs will allow.

Peptide Purgatory, published whenever I feel like writing, mixes one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia. Ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: GLP-1s and COPD appeared first on The Nittany Turkey.

My approach to plateau management is scientific. I obtained hard data and I use several measurement systems to eliminate guesswork and approximations. Does that sound like fun? Well, it isn’t, but to a systems guy, it’s a feedback loop that works. While programming one’s intake is boringly rigid, I build in enough flex that I don’t feel like I’m eating combat rations everyday.

Ultimately, GLP-1s stop doing the heavy lifting. Appetite suppression fades, and the old signals start creeping back. My experience parallels others who have reported the loss of effectiveness after a while. With the wholehearted encouragement of Big Pharma and the modern healthcare system, they might chase higher doses for a while until they reach the maximum, but then what? If they otherwise maintain status quo, they are simply postponing the inevitable plateau and rebound.

In my case, I chose to remain at a low dose of Mounjaro, namely 7.5 mg, for its glucose control effect after the “food noise” had returned. Now at that well documented plateau, what happens at this juncture is crucial. My priorities are maintaining lean body mass, preserving muscle, and keeping weight stable. Read on and I’ll tell you how I intend to do that.

If you’re looking for magic, stop here. Anyone who has excess weight and especially those of us who have been down the road of yo-yo dieting know that we need to make major, permanent lifestyle changes to lose weight and not rebound. Both dietary modification and resistance training are key improvements. Conquering food obsession is crucial. I sublimated that obsession to strength training.

When GLP-1 Drugs Lose Their Edge

Sumathi Reddy wrote an informative piece for the Wall Street Journal describing how many patients experience weight regain and return of “food noise” even while still on GLP-1 therapy (Mounjaro, Ozempic, Wegovy, Zepbound, etc.). This typically happens after 9–18 months at the point where weight loss plateaus.

The drugs continue to work, but the body’s compensatory mechanisms intensify over time. Obesity scientists describe the “disease” as a “biologically defended” condition, where the body actively resists weight loss and tries to return to its prior set point. The greater the weight loss, the stronger the biological pushback. This phenomenon is not unique to GLP-1s; it also occurs after bariatric surgery, just on a different timeline.

Clinically, physicians respond in several ways. They can adjust doses or switch drugs, for example, from semaglutide (Ozempic, Wegovy) to tirzepatide (Mounjaro, Zepbound) and emphasize protein intake and resistance training. As well, they can address sleep, stress, and diet quality. That’s one end of the deal; patient compliance is another story.

Stopping the drug makes things worse, but staying on it doesn’t eliminate the need for behavioral discipline. Doctors can do their part, but in the end, it is again the patient who must make permanent adjustments. And that’s what this article is all about.

The drug lowers the hill, but you’re still pushing the rock up that damn hill forever.

How It Works for Me

Although the WSJ article frames the phenomenon as “the drug losing its edge”, it is more complex than that. The underlying disease remains active and adaptive. I have Type 2 diabetes, and while I can control it with drugs, it does not go away.

The GI tract and metabolic signaling system are not static; they remodel in response to diet and obesity. Even interventions that dramatically alter physiology like gastric bypasses or duodenal mucosal resurfacing still require ongoing management because Type 2 diabetes is progressive and multi-organ. And that means hard work.

So, the real story isn’t “drug failure”. It is system compensation.

Although I didn’t know when it would happen, I knew that I would reach a weight plateau. In retrospect, I can place the stabilization point at June 2025, when I hit 170 after losing 79 pounds during the prior 12 months. By that time, I had already ramped up my resistance training to six days a week. Importantly, to support muscle maintenance and even growth I increased carbs and total calories in my diet.

In October, when my new doctor said, “I don’t want you losing any more weight,” I noted that I had been stable since June. But that comment by Dr. Macallan was a new first for me. My previous experience had conditioned me to arrive at doctors’ offices with my defense briefs prepared. The philosophical U-turn caught me off guard.

For those of us who have long carried excess baggage, a prominent feature of doctor visits is the inevitable question, “What are you doing about your weight?” My characteristically facetious response might be: “I’m watching my waistline. Watching it get bigger and bigger…” Or, “I can lose the weight, but there’s not much you can do about your ugly face.” Diversion tactics, to be sure.

Dr. Macallan brought me back to earth. I was at a plateau hoping to preserve that nominal 170 level. My problem was that it was all guesswork. What weight was my “ideal”? How many calories did I need to maintain it? How — and how much — did exercise bias the equation? Was I “big boned” (a laugh from the old fatso excuses)? Was I gaining muscle?

I needed answers. Others put themselves in the hands of registered dieticians, who serve a very useful purpose. However, I, the autistic, economy-minded engineer, prefer to research and develop my own solutions.

The GLP-1 Honeymoon Ends

After making those dietary adjustments, I noted that my weight could creep up a few pounds here and there, which intensified my quest for hard data. The “food noise” was gone, and my robust appetite returned. I added bread — blessed bread, the staff of life — and opened the floodgates. Between December and March, I was up to 179.

I didn’t panic. Noting the state change, I sought answers. The engineering solution demanded knowledge of the relevant variables and ability to control them. I had to know the flow rate before I could adjust the valve. And that valve was the failure point compromising the integrity of the system.

The Engineering Reality: Biology Pushes Back

Weight regulation is a closed-loop control system. You input calories, activity, and pharmacology and output weight, blood glucose, and appetite. But there’s a hidden variable, which was identified in the WSJ article: adaptive metabolic response.

In my case, the drug didn’t “fail”. Far from it. It has controlled my glucose such that I have maintained HbA1c of 5.4-5.6%, below even prediabetic levels. However, the weight loss ceased. Thus, the system rebalanced.

Weight loss was always a secondary consideration in my Mounjaro therapy, but with the glucose stable, I shifted my focus to avoirdupois.

Approximations Are Not Good Enough

I use an app called MyFitnessPal to track my daily intake. Despite all its sophistication, including a database of every imaginable food, it can only approximate daily caloric requirements. While I get to set a baseline caloric goal and adjust macronutrients willy-nilly, some numbers required estimates, which could significantly deviate from reality. The scale gave me empirical proof of my flawed approach. I was slowly gaining weight, so I knew my intake was too high.

Most fitness trackers like MyFitnessPal apply categorized activity levels (sedentary, moderately active, very active, athletic) to calculate daily caloric expenditure. But what I need is finite numbers, not suggestive adjectives. Activity varies from day to day, so it cannot be neatly pigeonholed into one label or another.

Also, what is my baseline caloric expenditure, before activity even enters the picture? In other words, how much energy do I expend just existing with a beating heart, operating lungs, a digestive tract and a slightly dysfunctional brain? Again, MyFitnessPal and the like can only guess. And, as it turned out in my case, it guessed a few hundred calories too high.

A small caloric surplus — a couple hundred calories per day — will cause gradual weight gain over time. And that’s where I was — up to 179 in a few months.

The Inflection Point: Real Data Arrives

That bounce and its associated question marks impelled me to get hard data. A DEXA scan would reveal my lean mass and a realistic target body weight, while measuring resting metabolic rate (RMR) would give me my baseline calorie requirements. DEXAfit of Orlando provided the necessary data.

The DEXA scan revealed my body fat percentage to be 19% and my lean mass to be 137 lbs. My visceral fat was 1.93 lbs. And, yes, I am “big-boned”, because my bone density was in 3-4 sigma territory for my age group. All told, my “ideal weight” was estimated at 169 lbs.

Given all my yo-yo dieting in the past and the recent rapid weight loss, I anticipated that my RMR would measure low. The results confirmed it, and that is exactly where MyFitnessPal and I had gone astray. My RMR is 1398, classified by DEXAfit as “slow”. Adding in digestion and minimal daily activity raises it to 1678. Thus, if I sit here writing Nittany Turkey articles all day, I’ll need only 1678 calories from food to maintain my weight. That isn’t very much!

Nevertheless, those two diagnostic excursions gave me the numbers I needed for a more scientific MyFitnessPal diet tracking approach. I rounded the 1678 to 1700 because we all like to cheat a little bit. In this case, I was cheating upward about as many calories as a strawberry offers.

Then, I set my activity level to “sedentary”.

But, wait! Didn’t I tell you I was doing resistance training and cardio six days a week? How is that sedentary? Read on.

Rebuilding the Model: Implementing the Control System

I’ve already told you that I replaced the guesswork goal weight and daily calorie budget in MyFitnessPal based on hard data obtained at DEXAfit. But what about that energy expenditure I set to “sedentary”?

Well, Turkey readers, it turns out the MyFitnessPal is smarter than its dumb activity categories suggest. More intelligence lurks beneath the surface, for those of us who can dive into manuals and settings. You just need to give MyFitnessPal decent input and you’ll have a decent feedback loop. Coupled with a smart sensor device like my Garmin Venu 3 fitness smartwatch, it is a hard core fitness engineer’s dream tool.

When I work out or take a brisk walk, I enable the Venu 3 tracking feature to record estimated caloric expenditure. Its app is integrated with MyFitnessPal to provide that number, which MyFitnessPal “digests” and applies to not only my daily caloric requirement, but also, proportionately, to my macronutrient goals. For example, if my basic protein goal is 120 g/day and I record 170 calories of exercise, MyFitnessPal adjusts my total calories to 1870 from 1700 and total protein to 132 from 120. No more guesswork.

If I want to gain muscle mass, I will adjust calories and protein slightly upward. If I need to shed some ill-gotten pork, I’ll decrease calories and carbs a bit.

(I should note for readers who are anal retentive like me that when I use the term “calorie” in this context, I really mean kilocalorie.)

Thus, MyFitnessPal is a logging tool and a guide, not a decision engine. I replaced a heuristic system with a measured one. I’ll be pushing that rock uphill with much better knowledge of the force vectors involved.

The Role of Resistance Training (Non-Negotiable)

You cannot expect to “keep it off” unless you make those permanent changes I keep mentioning. Equally important as diet, and of paramount importance from a longevity standpoint, is resistance training. If you’re going to wage this fight with your body, you need a hardcore tool. That tool is serious strength training.

You need to work the big muscles with progressive overload—squats, deadlifts, presses. Serious work with meaningful weight.

Yeah, you can do your cardio if you like. Do your bike rides, take your walks in the park, or have your swims. But don’t skip the strength training. This is especially important for those of us in our golden years by which time the inevitable progress of sarcopenia has caused significant muscle loss. To maintain mobility and independence, you must show your body who’s boss!

Permanent Dietary Change: There’s That Word “Permanent” Again

Nothing is permanent including life itself. When I say “permanent”, I mean for the rest of your useful life. When those beneficial changes are improved diet and a serious commitment to exercise, that useful life will be extended.

The hype surrounding GLP-1 drugs like Mounjaro might reveal magical biohacks including “post-GLP-1 diets”. Sorry to disappoint, but this is a subject for later on, to be lampooned in our regular feature called Bullshit Corner. There is no magical off-ramp that will save your butt from broadening if you don’t pay heed to what real science tells you. And real science does not live on TikTok.

There is no “post-GLP-1 diet.” There is only your diet now. You didn’t get fat on a drug and while a drug might temporarily forestall the inflationary episode, it will not end it. After it gives you the boost you need to see that you can finally lose the weight, only your resolve to make the right decisions will determine your success or failure.

Despite what the “influencers” tell you, you cannot eat ultraprocessed foods and pile on empty calories while expecting weight loss to continue forever. These junk foods are just engineered overeating. Once the satiety effect of the GLP-1 is gone, regardless of whether you’re still on the drug or you discontinued it, you’ll be piling in ever increasing quantities of trashburgers. They’re engineered to make you want more; MCD stock price depends on that feature. They get rich while you condition yourself for failure. Again.

A simpler diet is a controllable system. On days when I eat in restaurants, I take liberties. If MyFitnessPal doesn’t know the ingredients in restaurant food, it can’t give me accurate feedback. (However its database includes some popular restaurant menu items). When I cook at home, a portion scale and known ingredients are my friends. Everything is known and controllable. How often do we find systems completely under control?

The Reality Check: This Is Chronic Management

Type 2 diabetes is a chronic, progressive condition. Obesity has been characterized similarly, although I have long resisted that “excuse”. (See my Bullshit Corner excoriation of “Obesity As a Chronic, Relapsing Disease”). Agree or disagree, “disease” or “condition”, obesity remains a problem to be addressed. GLP-1s are powerful tools, but not complete, prepackaged solutions.

GLP-1s do not replace vigilance, measurement, and discipline. But they can kick-start your engine and get that train headed in the right direction. You must do the rest.

The drug quieted the noise but it didn’t change the physics. Keep pushing that rock up the damn hill!

Peptide Purgatory, published whenever I feel like writing, mixes one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia. Ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: You Can’t Fool Mother Nature appeared first on The Nittany Turkey.

War Machine Cast and Premise

War Machine stars Alan Ritchson, better known as Reacher, his role in the Amazon Prime series of the same name. His co-stars include dependable (albeit aging) B-list regulars Dennis Quaid and Esai Morales. It was released in the U.S. on March 6.

Although scenes purport to be Afghanistan and Colorado, they were shot in New Zealand and Australia, which apparently now stand in for every rugged place on Earth that a production budget can’t quite afford.

The film begins looking like a standard modern combat story. Ritchson plays a character identified once as Sapper, but known throughout the rest of the movie by the thrilling call sign “81” (a perfect square). He survives a Taliban attack in Afghanistan in which his brother dies. Shortly before the attack, the brothers had agreed to try out for the Army Rangers together. Since survivor’s guilt is the most reliable motivational device in screenwriting, Sapper vows to complete Ranger training in his brother’s honor.

The Plot Twist

At this point, the movie appears to be following the well-worn Hollywood template: misfit candidate joins elite training program, instructors say he lacks the right stuff, adversity occurs, and our hero proves them wrong in dramatic fashion. Think Top Gun, An Officer and a Gentleman, and about three dozen other films in which the outcome is never in doubt but we pretend to be surprised anyway.

But then War Machine introduces its innovative twist: aliens.

The Final Training Mission

During the final Ranger weed-out exercise, the few remaining candidates are given a timed search-and-rescue mission in rugged backcountry. They must locate a supposedly downed aircraft, destroy the classified equipment onboard to keep it out of enemy hands, rescue the crew, and return within 24 hours. To make things interesting, the opposing force called “Cadre” is commanded by the villainous duo played by Quaid and Morales. Failure means no Ranger scrolls, which would clearly be the worst thing that could happen during the next two hours.

Because the officers don’t like him much, they put 81 in charge of the squad. Naturally, most of the team would rather follow 7, who has been leading them through much of the training. This creates predictable friction, especially from 15, who reminded me so strongly of Pete Davidson that I spent half the movie waiting for him to make a Weekend Update joke.

Eventually the squad reaches the wreckage of the supposedly downed aircraft. The candidates notice that the coordinates were off and their navigation gear appears to be malfunctioning, which is the sort of subtle hint that something unusual might be going on. They also note that the aircraft looks like DARPA went all out to give them state-of-the-art technology to blow up. Nobody thinks that might be a bit of a stretch in an era of waning military budgets.

The Real Target

Meanwhile, 81, who has wandered off to scout the area alone, discovers the actual wrecked aircraft. Instead of a modern military plane, it looks suspiciously like a Korean War-era fighter. By the time he returns to warn the others, however, the squad has already planted the explosives and detonated the charges.

The result is educational.

The C-4 blast does not destroy the wreckage. It doesn’t dent it. It barely inconveniences it. The “aircraft” simply stands up in full Transformer fashion and begins shooting flaming projectiles at the trainees. After they recover from the shocked realization that they were dealing with something otherworldly, a member of the squad exclaims, “It’s pissed off now!”

At that moment, even the most optimistic viewer will realize that the climactic “boss fight” will involve 81 and the alien Transformer.

The Chase

The remainder of the movie consists largely of the Ranger candidates running away from this thing while it stomps around the forest like an angry kaiju, producing thunderous footsteps and steadily reducing the cast list. Armored vehicles prove ineffective. Bullets bounce harmlessly off its exterior. The creature can fire straight-line energy blasts and also lob an apparently infinite supply of spherical explosive anti-personnel devices, which seems like an unfair advantage during a training exercise.

Eventually, after the usual cinematic attrition of expendable characters, our numerical hero figures out how to stop the thing. I won’t spoil the exact method, other than to say that the laws of physics take a brief vacation while it happens.

And in the End…

The film never clearly explains what the alien machine is or where it came from. All we know is that early news broadcasts mention an asteroid passing close to Earth. As you might suspect, it isn’t really an asteroid. By the time the dust settles, humanity learns that tens of thousands of similar objects are headed our way.

And in case you were worried, 81 earns his Ranger scroll and is immediately tapped to train the elite Ranger unit that will presumably handle the incoming alien invasion. Apparently the Army’s anti-extraterrestrial strategy begins with Ranger School.

On the whole, I found War Machine entertaining in the same way a well-made amusement park ride is entertaining. The action scenes are competently done, the pacing moves along briskly, and the question of how 81 will win (not whether) keeps things moving.

Is it great cinema? Not exactly. But if you enjoy watching a squad of Ranger candidates attempt to outwit a homicidal, “pissed off” alien Transformer in the woods, Netflix has thoughtfully provided two hours of your life that you will never get back.

And given the current state of Hollywood, that probably counts as a success.

The post Movie Review: War Machine (2026) appeared first on The Nittany Turkey.

We’ve reached the terminal-velocity phase of institutional entropy. Late Friday, the FDA announced that Vinay Prasad, chief of the Center for Biologics Evaluation and Research (CBER), is departing the agency again. This is the second time in less than a year he has signaled an exit. In a system this chaotic, the revolving door doesn’t just spin. It detaches from its hinges.

The “Sabbatical” Spin

In a move that would make any PR firm weep with envy, FDA Commissioner Marty Makary took to social media and internal emails to frame this as a planned victory lap. According to Makary, Prasad’s “one-year sabbatical” from the University of California, San Francisco (UCSF) is coming to an end, and he is simply returning to his “academic home” at the end of April. He made it sound like that had always been the plan. Yeah, right.

Makary praised Prasad as a “genius” who accomplished “a tremendous amount,” specifically citing his work on the “one-trial default” and the new “plausible mechanism” framework. This is a philosophy favored by Makary that would lower the evidentiary bar for some approvals. But if you look at the smoke billowing out of the CBER windows, the “sabbatical” excuse looks more like a strategic retreat from a battlefield.

The Reality of the Centrifuge

While the Commissioner talks about “reforms,” the rest of the world sees a system undergoing total heat death:

• The Moderna Flip-Flop: Prasad’s departure comes just weeks after he refused to review Moderna’s mRNA influenza vaccine submission. Within days the FDA reversed its decision following reported White House pressure. Reversing a refusal-to-file decision in less than a week is not standard regulatory choreography; it signals a breakdown in internal alignment at the top of the agency.
• The Rare Disease War: He has been in a sustained public spat with companies such as UniQure over gene therapy approvals for rare diseases, scuttling rare disease treatments that the agency previously agreed were on track for approval.
• The Internal Probe: Perhaps most damningly, Prasad is currently the subject of an internal FDA investigation into a “toxic workplace environment”. Staffers have accused him of berating subordinates and retaliating against reviewers who dared to question his “plausible mechanism” whims.

Another Hat, Another Head

In the true spirit of Operator Overloading, Makary has yet to name a successor, noting only that a search is “underway”. Given the current hiring standards in the “Clown Car,” we can only guess who is next. Will we get another sports-doctor-turned-drug-regulator like Tracy Beth Høeg, or perhaps another influencer from the RFK Jr. orbit?

Prasad’s first exit in July 2025 lasted less than two weeks before he was brought back to “resume leadership”. This time, with a workplace probe hanging over his head and the biopharma industry treating him like a regulatory pariah, the “sabbatical” might actually stick.

The Bottom Line

HHS is not being “disrupted” into a better system. It is being sandblasted by institutional friction. When your top vaccine regulator leaves twice in ten months amid lawsuits, industry revolts, and internal investigations, you do not have reform. You have a meltdown.

Stay tuned. The Clown Car is about to get another passenger, and if recent hiring patterns hold, they will arrive wearing at least three funny hats.

Peptide Purgatory, published whenever I feel like writing, mixes one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia. Ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post HHS Clown Car Loses a CBER Driver — Again! appeared first on The Nittany Turkey.

While GLP-1 receptor agonists have lately been credited with fixing everything from 1970 F-100 pickup trucks to bodybuilders trying to vaporize the last five percent of their body fat, the jury is still out on the long-term side-effects of this wildly popular class of semi-recreational pharmaceuticals that now accounts for 7% of all U.S. prescriptions.

Fatsos far and wide have hopped aboard the GLP-1 bandwagon in search of magical, no-penalty weight loss for the bargain basement price of $400 or $500 per month. Damn the torpedoes, they think. A little life-threatening pancreatitis or gastroparesis seems like a reasonable trade-off. After all, squeezing into that Size 5 dress clearly outranks all that tedious internal-medicine nonsense.

On the boys’ side—where the line between boys and girls appears to be undergoing some active beta testing—men who have carefully avoided the gym for the past thirty years are suddenly using GLP-1s to sculpt themselves into middle-aged Adonises. Physical effort remains strictly optional. Yes, they’ve heard rumors about muscle loss accompanying rapid weight reduction, but that surely applies only to other people. The approving comments from the ladies at work are validation enough.

Where the Boys Aren’t

Curiously, these newly minted Adonises are seldom spotted at the beach, where one would expect them to parade their abs and pecs in pursuit of Aphrodite. Perhaps this is because the abs and pecs quietly evaporated along with the fat, leaving behind a collection of wrinkles that resemble a T-shirt crumpled at the bottom of a long-abandoned gym bag.

Now, Another Thing to Worry About

But now the GLP-1 faithful may have something new to worry about and this one hits at their esthetic values—where it truly hurts. A real-world multicenter TriNetX cohort study spanning 2014 to 2024 reported a significantly increased risk of nonscarring hair loss among GLP-1 users compared with matched controls. Physicians are now being advised to counsel patients about possible hair shedding and to evaluate nutritional deficiencies or rapid weight-loss patterns if hair loss occurs.

Doctors, of course, will almost certainly ignore this advice. At least that has been my experience with physicians overseeing my own GLP-1 therapy for Type 2 diabetes. They don’t seem terribly interested in discussing even the more serious adverse effects. Baldness? If it happens, we’ll cross that bridge when the wind starts blowing across your newly unprotected scalp.

Unfortunately for the cosmetically ambitious, that moment may arrive sooner than expected. Those flowing locks that once framed their triumphant metabolic makeover may suddenly take flight.

Below, I present proof positive from a cohort study of one fat old diabetic who has been on Mounjaro (tirzepatide) since June 2024. At left is a photo from 2023; at right, from 2025.

Need I say more?

Peptide Purgatory, published whenever I feel like writing, mixes one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia. Ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: Lose Weight — AND HAIR — with GLP-1s! appeared first on The Nittany Turkey.

A Regulatory Agency in Search of a Compass

When I previously described the thermodynamic decay of HHS, I was being charitable. What we’re witnessing now at the U.S. Department of Health and Human Services and the FDA is not slow entropy. It is active rearrangement of the control panel while the reactor is online.

This week’s episode features the FDA, specifically CDER, the Center for Drug Evaluation and Research. For the uninitiated, CDER is not a podcast studio. It is the office that evaluates whether drugs are safe and effective before they reach the public. Small job. Light consequences.

The FDA Commissioner, Marty Makary, appears to be running a management experiment best described as “How Many Acting Directors Can We Cycle Through Before Lunch?”

The Fifth CDER Head in One Year

The new acting CDER director, Tracy Beth Høeg, is reportedly the fifth leader in a single year.

Historically, CDER directors are regulatory lifers. They understand statutory authority, evidentiary standards, advisory committees, and what constitutes signal versus noise in pharmacovigilance.

Høeg’s background is in sports medicine. She is also known for contrarian pandemic-era positions while associated with Center for Biologics Evaluation and Research under Vinay Prasad.

Sports medicine. Ultramarathons. No deep regulatory portfolio in drug approval pathways.

If CDER were a small biotech startup, this might be eccentric. CDER regulates trillions of dollars in pharmaceutical commerce and therapies that millions rely upon daily.

Operator overloading, indeed.

The Urato Petition and the SSRI Bomb

Now we get to the part where engineers begin checking for insulation breaches.

Dr. Adam Urato has filed a citizen petition asking the FDA to impose black box warnings on SSRIs used during pregnancy, alleging autism and brain injury risks. Major medical organizations, including American College of Obstetricians and Gynecologists, have reportedly rejected the evidentiary basis for those claims as weak and methodologically unsound.

Citizen petitions are not unusual. They are part of the administrative process. But here’s the governance problem: Høeg is reportedly close to the petitioner and is accelerating review of that petition.

Recusal is not an exotic concept. It is Governance 101. Yet here we have it: cronyism within cronyism.

If CDER leadership is perceived as advancing petitions aligned with personal networks rather than dispassionate review of data, then the agency’s credibility begins to erode. Not slowly. Catastrophically.

Pregnant women on SSRIs are not academic abstractions. Untreated severe depression carries real maternal and fetal risks. Regulatory signaling in that context must be anchored in rigorous epidemiology, not suggestive associations.

This Is Not Reform. It Is Systemic Drift.

When you have:

• A revolving door at CDER
• Leadership with thin regulatory credentials
• Petitions aligned with personal networks
• Politically charged public messaging

You do not have “modernization.” You have a closed feedback loop.

Engineers know what happens when feedback becomes self-referential. The system amplifies noise until it oscillates itself to failure.

Public trust in drug regulation is not a luxury variable. It is load-bearing infrastructure. If clinicians begin to suspect that labeling decisions are ideologically driven rather than data-driven, confidence collapses. Once that happens, every approval becomes suspect. Every safety communication becomes politicized.

That is how institutions die. Not with a bang. With administrative churn.

The Bottom Line

Regulatory agencies are supposed to be boring. Stable. Predictable. Procedural.

When they become personality-driven, network-driven, or ideology-driven, they cease to be regulators and become accelerants.

We need competence and process discipline. Certainly, we need recusal where appropriate. Finally, we need decisions that can survive hostile cross-examination in federal court and peer review in the literature.

Public health is not a podcast ecosystem.

If this trajectory continues, the “Clown Car” metaphor will be too generous. Clowns at least rehearse.

Stay observant. The load-bearing beams are creaking.

Peptide Purgatory, published whenever I feel like writing, mixes one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia. Ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: More HHS “Influencers” at the FDA appeared first on The Nittany Turkey.

We return to familiar territory: GLP-1 receptor agonist drugs such as Ozempic and Mounjaro. As you might recall, I have been on Mounjaro since June 2024 to control blood glucose. Along the way, I lost about 75 pounds of blubber. It is that side “benefit” of GLP-1 drugs that have driven their tremendous popularity over the past five years. A recent report found that 7% of prescriptions in the U.S. are written for GLP-1 drugs, which inspired me to write a summary of the report’s findings and speculate on where this whole GLP-1 thing is taking us.

Interspersed with that report is a recap of my current progress with Mounjaro. I have become so enamored of reporting on GLP-1s and HHS that I’ve neglected that aspect of this regular column and my readers have noticed. Sorry about that! I mean, what the hell is Peptide Purgatory without the devilish Nittany Turkey dwelling on himself, anyway?

Additionally, Bullshit Corner covers a new fad. Apparently, someone discovered that starches are harder to digest if they’re chilled, so people are now refrigerating their cooked rice and potatoes, thinking they’ll lose weight. As I’ve said many time in Bullshit Corner, you can’t make shit like this up! TikTok influencers are leading people to believe they can have their cake and eat it, too, so to speak—as long as it sits in the fridge overnight.

So, thanks for visiting. I hope you’ll find these stories entertaining.

The Incretin Inertia and the Trillion-Dollar Tilt

If 2024 was the year of the “Ozempic Face,” 2025 has become the year of the “Tirzepatide Takeover.”

A new report from Truveta Research, analyzing data through December 2025, confirms what we’ve long suspected: we aren’t just using these drugs; we are becoming a GLP-1 nation. As of the end of 2025, GLP-1 receptor agonists now account for over 7% of all prescriptions in the United States.

The Truveta Findings: A Tale of Two Tides

The December 2025 data reveals a fascinating divergence. While overall prescribing rates increased by 5% in the final quarter of the year, first-time prescriptions actually dipped by 6.6%.

What does this mean? The “Gold Rush” of new users is stabilizing, likely due to seasonal holiday trends and market saturation, but the existing user base is becoming “sticky.” Patients aren’t just trying these peptides; they are staying on them. Tirzepatide (Eli Lilly’s Mounjaro/Zepbound) has officially unseated semaglutide as the king of the Hill, showing the largest growth in volume. However, the “dispense gap” remains a hurdle: while over 70% of diabetic patients fill their scripts, only 47.5% of those prescribed for obesity actually walk out of the pharmacy with the drug—a victim of high costs and insurance “purgatory.”

Corporate Wealth: The $1 Trillion Milestone

This prescription surge has fundamentally rewritten the hierarchy of Big Pharma. Eli Lilly made history in late 2025/early 2026 by becoming the first healthcare company to hit a $1 trillion market capitalization. Driven by a staggering 45% revenue growth in 2025 ($65.2 billion total), Lilly has effectively “leapfrogged” its Danish rival, Novo Nordisk (Ozempic/Wegovy).

In contrast, Novo Nordisk has entered a period of relative cooling. After pioneering the space, Novo saw its stock price nearly halve in 2025. Investors, spooked by supply bottlenecks, the rise of compounded semaglutide, and disappointing trial data for their next-gen drug CagriSema, have shifted their “peptide premium” over to Lilly. If you had invested in Novo at the start of the Ozempic boom in 2019 (at ~$23/share), you would have seen it peak near $142 in mid-2024—a 500% gain—before watching it slide back toward the $50 range by early 2026. Still a win, but the “Easy Money” phase has clearly exited the building.

The Physical Cost: Gallbladders, Gout, and Bones

As we flood the population with these peptides, the epidemiological “bill” is coming due. The trend is moving toward higher-dose, long-term use, which has correlated with several specific clinical “purgatories”:

• Gallbladder & Pancreas: Recent reviews confirm a heightened risk of gallbladder disease (cholelithiasis and cholecystitis), driven by slowed biliary motility and rapid weight loss. While the “pancreatitis scare” has cooled—with meta-analyses showing no significant risk in most healthy populations—clinicians are still seeing “biliary sludge” that can trigger acute attacks in high-risk patients.
• The Bone & Gout Paradox: In a surprising twist, new research presented at the March 2026 AAOS meeting suggests a 30% increased risk of osteoporosis among long-term GLP-1 users. Researchers compare the effect to “astronauts in space”—without the “loading” of excess weight, and with potential nutrient deficiencies, bone density is cratering.
• Gout: While some studies suggested GLP-1s might reduce gout flares due to anti-inflammatory effects, real-world data from 2026 shows a 12% increase in gout rates. Rapid weight loss often causes spikes in uric acid, proving that even “good” change has painful consequences.

A Side-Trip: Summarizing My Experience

As for this Turkey, my Mounjaro dose remains low with no apparent acute side-effects, although a recent gout flare is suspect. However, I’ve had a history of elevated uric acid and gout flares that predated Mounjaro, so it could be unrelated to my GLP-1 use. My recent DEXA scan confirmed that my bones are still in decent shape, too. As for potential longer-term negative effects, at 79, how long a term are we talking about?

My weight has been stable since June 2025. I lost 75 pounds in my first year on Mounjaro. My current impetus is to preserve and increase muscle mass, to mitigate the muscle wasting effects of rapid weight loss, something also associated with GLP-1s. However, I’m continuing on Mounjaro for Type 2 diabetes blood sugar control, adjusting my diet with increased protein and a small caloric surplus. Although I have increased my carbohydrate consumption significantly in conjunction with my anti-weight loss campaign, HbA1c, the longer-term measure relating to blood glucose, has remained in the 5.4-5.6% range for the past year.

The Continuation: What Lies Ahead?

I predict the “Peptide Purgatory” will only deepen. As Novo Nordisk pins its hopes on Oral Wegovy (launched January 2026) to reclaim market share, the barrier to entry for users will drop even further. We are moving from a world of “injections for the obese” to “pills for the slightly overweight.”

The ramification? A society that is metabolically “better” on paper but physically “fragile.” We are trading the metabolic syndrome for the risk of brittle bones and biliary surgery. For Eli Lilly and Novo Nordisk, the trend is a golden goose; for the rest of us, it’s a high-stakes experiment in biological engineering.

Stay tuned—and keep an eye on your bone density. As long as my HbA1c stays under 5.7% and my bone density is measurably excellent, I’ll be continuing the Mounjaro.

And now, make sure your refrigerator is plugged in. You’ll need it in view of the following!

Peptide Purgatory, published whenever I feel like writing, mixes one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia. Ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: The State of GLP-1s appeared first on The Nittany Turkey.

It is now March 1, which makes it official. At the February 14 Board Meeting, the 3905 Century Club Board of Directors, in a 12–0 vote with one director absent, acknowledged my retirement after ten years of service by donating the Club’s laser printer to me.

Of course, per the 3905 Century Club Constitution, it is entirely possible that I should have waited until April 1 to acknowledge this gift.

Article I, Paragraph D.2 declares:

“Motions that do not state an effective date become effective on the first day (UTC) of the following month which begins at least 15 days following the date of the adoption.”

The February 14 meeting occurred on February 15 UTC, the Club’s reference time standard. Fifteen days takes us to March 2. Therefore, the effective date for the resolution would be April 1. But who other than I pays attention to such things?

April 1 would have been perfect for obvious reasons. But I am nothing if not procedurally flexible.

I am genuinely grateful for the recognition of my ten years of service, especially with such a useful gift. (If I can ever afford the toner for it.) That printer—or its predecessor—has occupied one corner of my upstairs office for a decade. It is so familiar that losing it would have been like saying goodbye to a childhood pet goldfish. Slightly dusty, occasionally temperamental, but fundamentally reliable.

A Recognition Like None Other

The Club knows I am a practical man. I do not require engraved keepsakes or ceremonial glassware. Hell, I created those kinds of things for others, which was my reward.

Peter, a longtime director, received an engraved silver bowl for his many years of service. Dean, our on-again, off-again president, received an engraved crystal microphone in recognition of his leadership. Both were presented with appropriate ceremony and admiration.

In my case, the Board chose utility and synergy.

Utility, in that I can now print hundreds of pages of full-color documents—an activity for which 79-year-old retirees are widely known.

Synergy, in that no one had to solve the thorny engineering problem of shipping a 40-pound printer from Florida to New York.

Wins all around.

And the ceremony? An email from the president: “We’re giving you the printer.” I believe there was a “thank you for your service” in there somewhere. I may have imagined the fanfare.

So I created my own ceremony, courtesy of my Brother P-Mate labeler.

Affixed to the slightly used device is the following dignified inscription:

3905 CCN
AWARDS SECRETARY
2015–2025
PROPERTY RETIRED

No crystal. No bowl. Just thermal adhesive permanence.

the Irony

Am I complaining?

Not in the least. I’m done, I know what I contributed, and I have no need for trinkets to validate ten years of work.

However, I’m simply amused by contrast.

Peter receives a lifetime-style keepsake; two years later, he’s back on the Board. Dean receives a ceremonial microphone; two years later, he runs again after declaring himself finished. Perhaps the microphone doubles as a recall device.

In my case, I am truly retired. No return campaign, no encore. I will remain a loyal member, but my volunteer chapter has closed.

So instead of an ornamental symbol of service, I received a depreciating asset that requires periodic infusions of four proprietary color toners.

Which, when you think about it, is deeply appropriate.

Institutional Memory

I am genuinely pleased to see that Rich has taken firm hold of the Awards Secretary role and that awards are again being pumped out after only a modest delay. That was always my objective: that the system function smoothly without me.

Volunteer organizations are closed systems. Energy is applied. Work is done. Entropy accumulates. Elections occur. Policies are debated. The Gang That Couldn’t Shoot Straight occasionally reloads. And yet, somehow, certificates continue to arrive in mailboxes like clockwork.

That is as it should be.

If I have any hope for the next five years, it is that the printer and I both remain operational long enough to celebrate the occasion. It will require toner, firmware updates, and the occasional clearing of paper jams. But that is true of most institutions.

The Closing

In the end, the printer is a fitting metaphor.

It rendered thousands of awards over a decade, consumed toner at a steady rate, required maintenance, and it occasionally flashed cryptic warnings. And when its duty cycle under one operator was complete, it was transferred—efficiently, practically, and without ceremony.

Toner levels decline. Entropy increases. The closed loop tightens. The Board meets. Pravda publishes. The Gang regroups. And somewhere in the background, a laser printer hums, doing what it has always done.

I will keep it well fed and occasionally amused.

After all, it and I are both retired property now.

All joking aside, thank you all for a highly rewarding decade.

The post Humorous Reflections on Ten Years as Awards Secretary appeared first on The Nittany Turkey.

Welcome to another All-Bullshit issue!

Peptide Purgatory, published whenever I feel like writing, mixes one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia. Ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Casey Means: Why? appeared first on The Nittany Turkey.

The drama at HHS continues. Dichotomies abound with “influencers” (better known as “disruptors”) running the show at the FDA. Now, we have Marty Makary making public pronouncements via the New England Journal of Medicine and the Wall Street Journal while underling Vinay Prasad prosecutes an opposite agenda. Even the WSJ, typically supportive of Republican administrations in Washington, is condemning the FDA clown car.

Meanwhile, the State of the Union address provides fodder for the current Bullshit Corner. Lots of healthcare hyperbole from the nation’s Bullshitter-In-Chief demonstrated a lack of mathematical acuity to accompany his penchant for overdramatizing false remedies for unsolvable problems. Get your shovel out and let’s dive into the pile!

The Heat Death of HHS: Policy by Op-Ed and the Great WSJ Civil War

If you want to observe a bureaucracy approaching thermodynamic equilibrium, you do not consult the Federal Register. You read the opinion pages.

In my previous installment, Peptide Purgatory: Multiple Hats for Too Few Heads, I suggested that the Department of Health and Human Services is drifting toward a closed-system meltdown. Too few operators. Too many levers. A fetish for disruption masquerading as governance.

This week, entropy went public. The internal debate at the U.S. Food and Drug Administration is no longer confined to advisory committees and briefing documents. It is being litigated in the opinion pages of the The Wall Street Journal.

This is heat, not strategy.

Phase I: The Marketing Gloss

On Wednesday, FDA Commissioner Marty Makary published a sunny column in the Journal outlining a streamlined path for rare-disease drugs. The message was reassuring: flexibility, speed, “one-trial default,” and a renewed focus on plausible biological mechanisms. The FDA, we were told, is nimble and patient-centered. It read like a glossy annual report.

In isolation, it sounded almost sensible. Rare diseases pose real challenges. Small populations, ethical constraints, and imperfect endpoints. Regulators must occasionally accept uncertainty in exchange for access.

Nothing controversial there. This is the nature of orphan drug policy.

But the trouble with press releases disguised as op-eds is that reality has a nasty habit of publishing the sequel.

Phase II: The Editorial Counterstrike

Within 24 hours, the Journal’s own editorial board issued a rebuke that bordered on incredulous. While Makary was promoting regulatory flexibility, the board alleged that his deputy, Vinay Prasad, had intervened to stall or block rare-disease approvals.

The editorial framed it bluntly: one man speaking the language of expedited compassion; another enforcing evidentiary maximalism.

You could not script a cleaner illustration of policy incoherence.

This is what I will call the Entropy Paradox:

• The Commissioner describes a high-efficiency, low-friction regulatory system.
• The Deputy applies friction.
• The public is left to infer which vector represents actual policy.

When the message and the mechanism diverge, you have noise, not reform.

Operator Overloading, Opinion Edition

I have used the engineering metaphor before, and it remains apt. If you overload a system with too many functions running on too few processors, performance degrades. If those processors begin arguing through newspaper columns, performance collapses.

The FDA is a 18,000-employee agency charged with safeguarding external inputs to our bodies. It cannot be governed by manifestos in the “Perspectives” section of a medical journal one day and op-eds the next.

Policy belongs in guidance documents, rulemaking dockets, advisory committee transcripts, and formal decisions with articulated standards. When it migrates to opinion pages, it ceases to be policy and becomes theater.

The result is not disruption. It is signal loss.

The Signal-to-Noise Ratio

Consider the practical question faced by a small biotech developing a gene therapy for a rare disease:

• Is the “one-trial default” truly operative?
• Will plausibility suffice if endpoints are imperfect?
• Or will a last-minute intervention redefine “substantial evidence” upward?

Markets abhor uncertainty, but even worse, patients suffer under it.

The FDA has always walked a tension line between caution and access. That tension is healthy when it is internal and structured. It becomes pathological when it is external and performative.

If Commissioner and Deputy disagree on evidentiary thresholds, that debate belongs in memoranda, not dueling columns.

The Broader Thermodynamics

This episode is not isolated. It reflects a broader trend toward what I previously described as “regulatory improvisation.” Authority is asserted through rhetoric. Constraints are dismissed as legacy artifacts. Institutional memory is treated as optional firmware. These are actors, playing roles in whatever way they interpret the script.

But bureaucracies are not startups. They are load-bearing infrastructure. You cannot swap out evidentiary standards the way you pivot a marketing campaign. Drug approval is not a podcast debate. It is a legal determination that affects lives, capital flows, and public trust.

When an agency’s clearest communication channel becomes the editorial page, entropy is no longer theoretical. It is operational.

The Bottom Line

The Wall Street Journal civil war is less about ideology than about coherence. If the FDA’s policy must be decoded from successive opinion columns, the system is not streamlined. It is fragmented.

A functioning regulatory agency may be slow. It may be conservative. It may frustrate innovators. But it must be predictable.

Without predictability, we do not get faster cures. We get capital flight, strategic gaming, and patients trapped between optimism and obstruction.

That is not reform. That is heat without work.

And heat, left unchecked, tends toward equilibrium.

Now, we turn our attention to the healthcare promises of Tuesday’s State of the Union theatrical performance. Talk about clown cars!

The post Peptide Purgatory: FDA WARS appeared first on The Nittany Turkey.

Resting Metabolic Rate: The Sloth Report

This week’s adventure in self-experimentation took me back to DexaFit for a resting metabolic rate (RMR) test. For the uninitiated, RMR measures how many calories one burns doing absolutely nothing except remaining inconveniently alive. It is indirect calorimetry — oxygen in, carbon dioxide out — and it is about as close as we get to an honest metabolic baseline without being locked in a university metabolic ward.

Testing my metabolic rate serves a purpose beyond merely satisfying my curiosity. I will use the refined total daily energy expenditure (TDEE) to ensure that I am feeding myself properly to maintain lean body mass. If I pork up a few pounds, I’ll have a better idea about how to shed them without starving my ass.

Preparation required an overnight fast, no caffeine, no exercise, and a reasonably calm state. I complied. The lack of caffeine alone should qualify as a clinical stress test.

Getting Set Up—Or Set Down, Maybe

Things began uneventfully. Technician Ken was fifteen minutes late, which I elected to interpret as additional parasympathetic priming. He led me to a small room with a computer console, a wall-mounted TV, and a comfortable-looking chair with matching ottoman. Before I could sink into it, Ken wanted to fit a breathing mask on me. Once that was done, I could relax in the chair—or so I thought.

In a moment of questionable spatial judgment, I sat on the ottoman, attempted to scootch backward into what appeared to be a stable lounge chair, and promptly tipped the entire contraption over. With such a clatter that it undoubtedly woke up the sleepy receptionist, the chair hit the wall and I landed on my ass with sufficient theatricality to require Ken to assist me up like an offensive lineman helping a running back off the turf.

While Ken feigned deep concern, I laughed it off. No need for damage control. Let’s get this show on the road! No pain, no lawsuit—just a useful advisory for future customers: that damned chair is not anchored. You have one problem, Sully: gravity!

Get This Damn Thing Started!

Once I was off the deck and properly seated, Ken clipped a pulse monitor to my finger. My heart rate was 70. My baseline resting heart rate (RHR) on the final report: 54. So yes, there was a brief sympathetic surge. Gravity will do that. Fortunately, heart rate declines faster than pride.

While we’re on the subject of heart rate, my 54 puts me in “elite conditioned athlete” territory, greater than two standard deviations below the norm for my age cohort. According to DexaFit, many factors can influence your RHR, including stress and anxiety, circulating hormones, and medications. Exercise is one of the most reliable ways to lower your RHR.

That wall-mounted TV I mentioned wasn’t there to let me watch last night’s NBA slam-dunk highlights on SportsCenter. Instead, it was supposed to provide calming images and gentle sounds. In other words, it was annoying as hell—swaying, snow covered fir trees with a mountain backdrop and weird fluffy clouds rapidly evolving above the scene. Scary shit! And the accompanying noise that purported to be music could only be described as lugubrious. But I digress.

Ken headed for the door, darkened the room, and told me he’d be back, reminding me not to fall asleep. No need to worry about that, as I was focusing all my available energy on attempting to telepathically turn off the damn TV.

Still Alive in There?

Ken needed to return once when the bradycardia alert broke my silent reverie and interrupted my seething at the trees. When the alarm went off, he treated my sub-50 heart rate with the same urgency one treats a low-battery chirp on a smoke detector. It turns out that when you spend your weeks wrangling 8,000 lbs of iron, your heart becomes so efficient it occasionally bores the medical equipment to tears.

Speaking of boredom, when Ken left, he told me I had to put up with another five or six ennui laden minutes. Whoop-de-doo! Just that damn TV and I staring at each other for what would seem like an eternal, unblinking stand-off.

Finally, after the prescribed period of lying still beneath those supposedly soothing images of snow-covered trees and drifting clouds — the sort of visual narcotic that apparently calms normal people — the numbers were in.

And Here are the Results

My measured RMR: 1,398 kcal/day.
Predicted: 1,480.

The machine calls it ‘Slow.’ I call it ‘Low-Idle Efficiency.’ Having shed 76 lbs of aerodynamic drag, my system has learned to keep the factory lights on using less fuel. It’s not a malfunction; it’s a feature of a 176 lb engine that no longer has to pull a 249 lb trailer.

The 82-calorie gap between predicted and measured is within normal biological variance. That difference represents roughly half a banana. Hardly a metabolic catastrophe. More importantly, my respiratory exchange ratio (RER) was 0.82. An RER of 0.82 confirms that my 5.5% A1c isn’t just a paperwork victory. Even at rest, I’m burning 60% fat. I’ve successfully transitioned from a high-glucose inferno to a steady, fat-burning furnace. I’m metabolically flexible—something most 79-year-olds (and plenty of 40-year-olds) haven’t managed.

The Biological Age Bullshit

DexaFit also adjusted my so-called “biological age”, previously determined by the DEXA scan as 68, downward to 64. Given that my chronological age is 79, I will accept any discount the actuarial tables are willing to grant. However, please don’t tell Medicare—I don’t want to lose my welfare state entitlement by descending through the threshold age!

Putting It All Together

The practical application of this data is straightforward. With an RMR of 1,398 kcal, and a realistic activity multiplier of about 1.5 given my workout habits, my total daily energy expenditure lands around 2,100 kcal. The 4–5 lb jump on my $20 Renpho scale this month isn’t a ‘fat-pocalypse.’ With a measured TDEE of 2,100 and an intake of 2,300, coupled with a daily creatine dose, I’m intentionally over-fueling the ‘Wet Muscle’ expansion. That modest surplus is the reason 135 lbs on the bench moved from ‘existential threat’ to ‘Tuesday morning routine.’

Data without context is noise. Data with training response is insight. I use MyFitnessPal to track calories and macros. This report will give me better guidance going forward.

The RMR test did not reveal metabolic doom. It confirmed that:

1. I am not under-eating.
2. My mild caloric surplus is intentional and measurable.
3. Strength gains are occurring alongside modest weight gain.
4. Falling off furniture does not permanently accelerate metabolism.

As with glucose control, resistance training, and most matters of aging physiology, the lesson is incremental, not dramatic. Measure, adjust, reassess, repeat.

So, the audit is complete. I have the bone density of a 30-year-old, the heart of an elite athlete, and a biological age of 64. I’m basically a high-performance vintage car that’s been retrofitted with a Tesla battery. Now, if I could just master the physics of a stationary ottoman, I’d be dangerous.

The post DexaFit Revisited: Will You Still Need Me When I’m 64? appeared first on The Nittany Turkey.

The University of Maryland, the alma mater of Sergei Brin and Boomer Esiason, has turned its formidable brainpower toward another kind of boomer: your flatus. Yes, dear readers. They are studying your farts.

This is not a metaphor. Researchers have developed “Smart Underwear” to conduct the study of your gaseous emissions.

Study participants wear a coin-sized hydrogen sensor clipped to their undergarments. It communicates with a phone app via Bluetooth using the same sort of low-power wizardry found in fitness rings and smartwatches. Except instead of heart rate variability or REM cycles, it monitors the velocity, volume, and hydrogen concentration of your exhaust plume.

One assumes California legislators are watching closely. Never let a quantifiable emission go unregulated.

The Science of Flatulence

Before we descend into adolescent snickering, the science is not entirely ridiculous. Roughly 40% of adults report digestive distress. Gas production reflects bacterial fermentation, fiber tolerance, and gut microbiome composition. Current data rely on self-reporting, which is notoriously unreliable because most of us neither count nor catalogue our emissions with laboratory precision.

Continuous hydrogen sensing could help correlate diet with gas production, potentially identifying patterns relevant to IBS, dysbiosis, or other gastrointestinal disorders. In other words, this is not just fart humor. It is microbiome telemetry.

But let us not pretend this will remain confined to serious gastroenterology.

A Nascent Billion Dollar Biohacking Franchise?

Biohackers will embrace this faster than they embraced cold plunges and CGMs. Soon enough, someone will be plotting daily flatus output against macronutrient intake and declaring victory over chickpeas. The quantified-self crowd will want dashboards showing each event as a bar graph, complete with intensity metrics and trend lines. I await the first firmware update that promises improved methane discrimination.

AI will surely enter the picture, so prepare for flowery olfactory notes:

“Hints of sulfur, subtle legume finish, medium persistence.”

Overwhelming Demand

The market appetite is obvious. The study’s homepage currently declares that enrollment in the Human Flatus Atlas is paused due to overwhelming demand. There is a waitlist. A waitlist. For fart monitoring.

Naturally, I signed up. Surely they require a well-aged hydrogen contributor to diversify the dataset.

The qualification criteria are mercifully simple: over 18, residing in the United States, not lactating, and willing to photograph every meal for three consecutive days. Instructions include LED color codes, charging procedures, and cleaning protocols. Blinking purple means “measuring,” which is reassuring in ways I cannot fully articulate. Participants are advised not to submerge the device or charge it while wet, advice that seems both obvious and necessary.

After the study concludes, the sensor is disposed of according to local lithium-ion battery regulations, which feels like an understated end for a device that has spent its operational life in the blast zone.

The top 3% of participants will be offered gut microbiome sequencing and awarded a plaque declaring them a “Prodigious Hydrogen Producer.”

There are achievements in life one does not anticipate. This is one of them.

I’m In!

I quickly received an email from “donotreply@umaryland.edu”, which stated, “Based on your responses to our Eligibility Survey, you’re eligible to participate in our research study: The Human Flatus Atlas – a nationwide effort to better understand digestive health using an innovative, wearable device nicknamed Smart Underwear. The Smart Underwear device is the size of a quarter and is worn on the outside of your underwear.”

The email went on to say that if I decide to participate, I’ll sign a consent form and will need to complete the survey. I’ll receive the Smart Underwear device in the mail. Then I must wear the thing for three days, 24 hours each day, and complete a post-wearing survey.

Phase 3 participants like me receive no compensation other than the satisfaction of giving our farts to science. I’ll receive data about my flatulence patterns, along with a comparison to others participants’ output. All anonymous, of course.

Oh, and if I want, I can wear the device for up to 30 days, but only three full days of participation are required. Unpredictable consequences await those who disobey the admonishment to not wear the Smarty Pants beyond 30 days. Good Morning, Mr. Phelps. Your ass will self-destruct in 30 days.

Final Thoughts from the Front Lines of Flatulence

So there you have it. At 79 years of age, after a several careers followed by retirement and volunteer service, and after hoisting much iron, hiking ten miles for fun, and monitoring my glucose like a NASA launch sequence, I have finally arrived at my destiny: Bluetooth-enabled butt telemetry.

No stipend, no gift card, and no commemorative T-shirt. Just the quiet satisfaction of knowing that somewhere in Maryland, a server rack may soon log my hydrogen output and plot it against a national average.

Three days, twenty-four hours per day. Continuous monitoring. I assume my Dexcom Stelo, my Garmin Venu 3 and this new device will negotiate airspace rights.

Go for the Flatulence Gold!

I am particularly intrigued by the comparative analytics. Nothing says “healthy competition” like discovering whether one ranks in the 62nd percentile of methane propulsion. Perhaps this will become the new VO² max. Instead of “What’s your bench?” it will be “What’s your baseline ppm?”

And if I choose to extend participation to thirty days? Well, at that point I suppose I will be committing to longitudinal gas research. A man must draw the line somewhere.

In the end, though, this is what science looks like in 2026: miniaturized sensors, edge computing, and a willingness to quantify what previous generations politely ignored. If better digestive health emerges from this exercise, I will gladly endure the blinking purple LED of destiny.

Should I earn the coveted title of “Prodigious Hydrogen Producer,” you will be the first to know.

For science, Turkey readers. Always for science.

Epilog: OOPS!—I’m Not In

When I clicked on the consent form link in the email, I was directed to a page with a disappointing message:

Further developments as they occur…

Peptide Purgatory, published whenever the hell I feel like it, albeit sometimes weekly, is a wholly owned subsidiary of The Nittany Turkey. It mixes one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity with a veritable plethora of opinions on each subject.

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: Pull My Finger! appeared first on The Nittany Turkey.

O’Neill’s tenure was coming to an end because temporary appointments can last only 210 days. So says the Vacancies Reform Act. So, absent a formal nomination to the position, O’Neill must step aside. But fear not. Good cronies, like kittycats, always land on their feet. O’Neill’s next stint will be heading up the NSF, a role that better suits his biotech investor background. Well, maybe.

Back to Bhattacharya, one problem is that he’ll be heading up two agencies in two physically disparate locations. NIH is in Bethesda, Maryland, while CDC headquarters are in Atlanta. But currently in this administration, operational effectiveness is taking a backseat to cronyism. Trump wants loyal “disruptors” wherever he can put them. This means one trusted workaholic may wear several hats.

Does this sound familiar? Later, I’ll relate it to my experiences in the microcosm of my favorite entropy model, the 3905 Century Club. For now, though, let us continue our exposition of entropy in the Department of Health and Human Services.

The Heat Death of HHS: Operator Overloading and the Closed System of Cronyism

In my earlier dispatches in this series I’ve argued that the Department of Health and Human Services is undergoing a total thermodynamic collapse. But if you want to know why the “system” is failing to finish even basic work, you must look at the architecture of the second Trump Administration.

The latest fuel for the fire comes from Fox News, detailing how the new regime is operator overloading its top brass. In programming, operator overloading allows a single symbol to do different things depending on the context; in the federal government, it’s a recipe for maximum entropy.

Endemic to organizations where loyalty outranks breadth of skill, authority compresses around the trusted few. That compression often feels decisive but it is rarely durable.

The Closed System: Where New Ideas Go to Die

The Second Law of Thermodynamics tells us that in a closed system, entropy—disorder—always increases. By staffing HHS, the FDA, the NIH, and the CDC with a tiny, tight-knit circle of “disruptors” who all think exactly alike, the administration has created a perfectly closed system.

When you appoint Marty Makary to lead the FDA and Vinay Prasad to lead CBER, and then have them co-author manifestos in the NEJM, you are getting a feedback loop, not diverse perspectives. There is no external energy (in the form of dissent or traditional skill) entering the system to keep it organized. The result? Total chaos, exemplified by the Moderna 168-hour flip-flop.

Operator Overloading: The “Multiple Hats” Scam

According to Fox News, the NIH Director isn’t the only one wearing multiple hats. We see a pattern where a handful of loyalists is being stretched across multiple agencies. On paper, this looks like “slashing the deep state.” In reality, it’s Operator Overloading.

When one person holds three jobs:

1. Bandwidth vanishes. No one can effectively run the FDA and set NIH policy and fight a “Maximum Pressure” campaign against mRNA vaccines at the same time.
2. Accountability evaporates. When the regulator (FDA) is essentially the same person as the researcher (NIH), the “checks and balances” required for drug safety become a joke.
3. Cronyism becomes the OS. Cronyism is not friendship. It’s a substitution of trust for institutional process.

This is why we see regulatory nihilism. The leaders are so busy overloading their schedules with political theater and journal submissions that the actual work of the agencies—like ensuring you can access life-saving peptides—gets ignored. The wheels of progress grind to a halt.

A Small-Scale Experiment in Entropy

I’ve seen this movie before. Not at the Department of Health and Human Services, but at the 3905 Century Club, an international ham radio award net organization. There, for a decade, I served as a volunteer officer and renaissance man for all seasons.

For eight of those years, we had a president who prided himself on getting things done—his way. What that meant in practice was that once he found someone competent and loyal, he piled everything onto that person.

During most of my tenure with the club, I held multiple concurrent volunteer positions. Among them were director, awards secretary, chair of the awards committee, member of the IT and bylaws committees, organizer of the mobile shootout, club registered corporate agent, and informal policy advisor. I also wrote regular columns for the newsletter, created graphic designs, and re-engineered a program that automated award entries. When the webmaster retired, I hosted the club website for two years until a replacement was found. I did everything besides sweeping the floor after meetings. (I didn’t need to—our meetings were conducted via Zoom).

Other examples of operator overloading in the 3905 Century Club abound. For example, the club treasurer is also a director, club information officer, membership committee chair, and net coordinator.

I’m not complaining. I took on my multiple responsibilities willfully and of my own volition. Those roles needed to be filled, and if not, by me, then by whom?

At first glance, that looks like synergistic efficiency. In reality, it is expedience. Redundancy is not inefficiency. It is civilization’s error-correction protocol.

When leadership narrows its trust radius, it doesn’t expand the team. It compresses it. Authority becomes concentrated not because it’s strategic, but because it’s comfortable. It is control, not leadership. And control masquerading as efficiency is the fastest way to close a system.

The Result: Institutional Friction

Scale up my minuscule club experience to the HHS level. When the same small cohort is running research, regulation, messaging, and strategic reform, you don’t get diversity of judgment. You get a party line and doublespeak. Cross-pollination is as necessary for survival in the organizational sphere as it is in the botanical realm.

We are witnessing the heat death of the American health apparatus. The friction between the Overloaded Operators (the loyalists) and the career friction (the remaining staff filing harassment complaints) is generating immense heat but zero forward motion: entropy.

But, friction is necessary to prevent catastrophic error; cronyism, on the other hand, enables it.

The WSJ Opinion page noted the absurdity of the Moderna walk-back, but they missed the underlying cause: The system is too closed to function. When you only talk to people in your own Bullshit Corner, you make amateur mistakes. You issue “Refusals-to-File” based on whims, and then you have to retreat when the reality of the multi-billion dollar market hits you in the face.

The result: a quick injection of external energy from the White House. Fix it, Marty and Vinay! That’s not a permanent solution; it’s putting out a pre-mid-term election fire.

The Bottom Line

I have watched a small organization collapse into functional paralysis because authority was compressed into too few hands. The problem was over-concentration, not malice.

At HHS, we are watching the same pattern at national scale. A handful of trusted operators are being asked to wear every hat, write every manifesto, and steer every agency at the same time.

Far from being reform, I can characterize these chaotic moves as dilettantish load-bearing improvisation.

Closed systems do not explode instantly. They overheat slowly. Then they fail.

The post Peptide Purgatory: Multiple Hats for Too Few Heads appeared first on The Nittany Turkey.

If you’ve been following my dispatches from Peptide Purgatory, you know my thesis: The Department of Health and Human Services (HHS) isn’t just failing; it’s undergoing a thermodynamic collapse. In physics, entropy is the inevitable move toward disorder. In Washington, entropy is what happens when you try to run the world’s most powerful regulatory body via op-eds, “vibes,” and 168-hour flip-flops.

The latest “fuel for the fire” comes from a Wall Street Journal editorial that pulls back the curtain on the Makary-Prasad “reform” era. And folks, the “Bullshit Corner” is officially overflowing, so while I shovel it out, I’ll make this a feature article.

Policy by Publication: The NEJM Manifesto

In a move that would make any fan of traditional governance shudder, FDA Commissioner Marty Makary and CBER Director Vinay Prasad just bypassed the boring, legalistic “rulemaking” process entirely. Instead, they took to the pages of the New England Journal of Medicine (NEJM) to announce a radical shift in drug approval standards.

Their “joint statement” essentially says: We’re done with the two-trial requirement. One study and a “plausible mechanism” is plenty. On the surface, it sounds like the “innovation” we’ve been begging for. But look closer. This isn’t a streamlined process; it’s an Entropy Accelerator. By shifting the goalposts from “substantial evidence” to “plausible mechanism” (a term so vague it could apply to a horoscope), they haven’t removed the bureaucracy—they’ve just made the bureaucracy arbitrary.

When the rules are whatever the two guys at the top decide to publish in a journal this week, you don’t have a regulatory system. You have a medical monarchy operating under the dubious aegis of the HHS clown car bureaucracy.

The Moderna Whiplash: Seven Days of Chaos

Nothing illustrates this increasing entropy better than the Moderna flu vaccine debacle. Last week, Prasad issued a “Refusal-to-File,” effectively killing Moderna’s mRNA flu shot because they used the “wrong” comparator. It was a move that smelled of the “Maximum Pressure” campaign currently being waged by Secretary RFK Jr. against anything mRNA.

Then, the WSJ reveals the internal combustion. Within seven days, the FDA did a total 180. No new data. No new science. Just a “resolution of a public dispute.”

This is the definition of wasted energy. The FDA spent a week setting itself on fire, only to realize the smoke was making them look incompetent, so they doused it with a “walkback” that leaves everyone—the industry, the doctors, and the patients—wondering who is actually steering the ship.

The Human Cost of Institutional Friction

Here is the irony that should make every Nittany Turkey reader’s blood boil:

• For Moderna: A multi-billion dollar corporation gets a high-level walkback and a seat at the table after a one-week tantrum.
• For You: If you are a patient in Peptide Purgatory, there is no “NEJM Manifesto” coming to save your access to Tirzepatide.

The “reformers” claim they are slashing red tape to help the “little guy,” but their actions suggest they are simply replacing old, predictable bureaucracy with new, chaotic ego-driven policy. While Makary and Prasad write op-eds about “plausible mechanisms,” actual patients are still being denied proven therapies because they don’t fit the “disruptor” narrative of the week.

The Bottom Line

The WSJ is right to be skeptical. We are seeing a civil war inside HHS where “The Disruptors” are clashing with “The Careerists,” and the result is total systemic entropy. Energy is being bled out through internal leaks, sexual harassment complaints (as reported), and policy-by-press-release.

As we barrel toward the mid-term course correction, remember this: A system with high entropy eventually reaches “heat death,” where no useful work can be performed. HHS is dangerously close to that point. They are so busy fighting each other and the ghost of vaccines past that they’ve forgotten their primary job: Protecting your right to manage your own health.

The “Bullshit Corner” is now the Main Stage. Buy a ticket at your own risk.

If you’re wondering how to survive the collapse, check out my recent deep dive on taking your health into your own hands—because the “experts” in DC are currently too busy editing their next NEJM submission to help you.

The post Clown Car Redux: The FDA Walkback appeared first on The Nittany Turkey.

My Tylenol research emanated from a Sunday family discussion stoked by the important question: whose mother took Tylenol while carrying which disaffected baby? This was, of course, a reaction to recent White House medical pronouncements.

Thus, mockery of the Trump Administration’s condemnation of the drug’s use by pregnant women evolved into a discussion of Tylenol history and applications. We meandered to related venerable analgesics, then they left my nostalgia trip behind as they moved on to other important gossip.

But my brain was stuck on Tylenol and memories of pain relievers in the 1950s. As old TV commercials and wild claims came flooding back from my still sound long-term memory, I was impelled to dig deeper and share what I would discover.

Tylenol is a brand name for acetaminophen, also known as paracetamol in the UK. We talked about how long the drug has been around, for one thing. Another gruesome topic we hit upon was its use as the favored method for ending one’s own life in the UK. We’ll cover both of those here.

So, Jenny and Aliya, this is the story of Tylenol, just for you (and anyone else who might be interested)!

The Beginning

While the ubiquitous red Tylenol boxes seem like a mid-century phenomenon, acetaminophen, the chemical itself has been around since the Victorian era. It was first synthesized at Johns Hopkins University by Harmon Northrop Morse in 1877. So it’s been around for 150 years, almost twice as long as this old Turkey.

Nonetheless, it really didn’t get much traction as a pain reliever at that time. Aspirin wouldn’t be trademarked by Bayer until 1899 as a powder, and it didn’t become a pill until 1915. So, something needed to be done about those Victorian headaches, but it wouldn’t be acetaminophen just yet.

In 1887, a related drug called phenacetin was discovered and became the market leader for decades, despite being quite toxic.

Meanwhile, acetaminophen was getting bad press, and it didn’t come from RFK, Jr. and the White House (just yet). A German physician named von Mering published a paper claiming acetaminophen caused a blood disorder called methemoglobinemia. This one “bad review” banished the drug to the shelf for 50 years while everyone was using aspirin and phenacetin instead.

The Breakthrough

But in 1948, Bernard Brodie and Julius Axelrod at the NIH proved von Mering was wrong. They showed that phenacetin actually worked because the body turned it into acetaminophen. They realized the “middleman” was the goldmine.

McNeil Laboratories finally launched Tylenol in 1955. They originally put it on the market as a liquid for children to avoid “aspirin stomach.”

It didn’t take off because it was better at killing pain than aspirin; it took off because it didn’t cause stomach ulcers or Reye’s Syndrome in kids, which gave it a massive marketing edge in the 1950s.

And now, before I get into the areas we discussed, I’ll take a side-trip to a little background I dug up.

ALL ABOUT TYLENOL

A little background will serve us all well here. I got lazy, so I let ChatGPT write this section. Some of this is over my pharmacological/medical head, but it will resonate with my med student step-daughter and my amateur physician wife.

Mechanism of Action

Acetaminophen is not a classic anti-inflammatory like aspirin or ibuprofen. It works primarily in the central nervous system, where it inhibits prostaglandin synthesis, likely via COX pathways in the brain rather than in peripheral tissues. It reduces pain and fever effectively but does very little for inflammation in a swollen ankle. In short, it quiets the thermostat and the pain circuits without meddling much in platelets or gastric lining.

Hepatotoxicity and the Antidote

At therapeutic doses, most acetaminophen is safely conjugated in the liver. A small fraction becomes a toxic metabolite, NAPQI, which is normally neutralized by glutathione. In overdose, glutathione stores are overwhelmed, and NAPQI begins destroying liver cells. The antidote, N-acetylcysteine (NAC), works by replenishing glutathione and can prevent liver failure if given promptly. Timing, as in most engineering problems, matters.

Modern Dosing Limits

For years, 4,000 mg per day was the upper safe limit for adults. Many manufacturers and clinicians now recommend lower ceilings, often 3,000–3,250 mg daily, especially for older adults or those with liver risk factors. The shift reflects caution rather than new chemistry. The molecule did not change; our tolerance for margin of error did.

Pregnancy Considerations

Acetaminophen was the analgesic of choice during pregnancy because it lacks the bleeding and ductus arteriosus risks linked to NSAIDs. Recent observational studies have raised questions about possible neurodevelopmental associations, but these findings are inconsistent and confounded by the underlying reasons for use. Correlation is not causation, even when headlines would like it to be. The current consensus still considers it acceptable when clinically indicated.

The APAP Problem

In the United States, acetaminophen often appears on prescription labels as “APAP,” shorthand derived from its chemical name. It is included in many combination products, especially opioid pain medications. Patients sometimes unknowingly double up, taking Tylenol along with an APAP-containing prescription, and exceed safe daily limits. In other words, chemistry is straightforward; labeling systems are not.

Mid-Century Headache Parade

So, acetaminophen has been around for 150 years, and its sister drug phenacetin (now defunct), has existed about as long. It works, but we still don’t know how.

Now, I’ll transition to some examples. We talked about which “old” over-the-counter drugs might have contained acetaminophen. Here’s what I found.

APC

In my youth, the immediate post-World War II Era, no medicine cabinet would be worth its bathroom wall space without a bottle of APC. This was the favored pain management pill of the 20th century military, cheap and somewhat effective. APC stood for Aspirin, Phenacetin, and Caffeine — all the good stuff in one convenient pill.

Phenacetin, as you’ll recall, was a somewhat toxic sister drug of acetaminophen, eventually pulled from the market in the 1970s for two major reasons. Medical studies linked long-term use to “analgesic nephropathy”, which meant it was destroying people’s kidneys. As if that wasn’t bad enough, other studies found it to be carcinogenic, producing increased risks of bladder and kidney cancer.

For the military, “A-P-C” wasn’t just a pill; it was a punchline. Because it was the default treatment for everything from a 102-degree fever to a twisted ankle, it earned nicknames like “All-Purpose Capsules” or “Army-Purpose Capsules”.

Back in the day, so many people (especially in the military and factory jobs) were popping these “A-P-C” generics like breath mints that they ended up with “APC Kidneys”—a specific type of kidney failure caused by the Phenacetin. It was a massive medical scandal that led to the FDA (and the UK’s equivalent) effectively killing off the “P” in APC by 1983.

Anacin

Remember the old commercials for Anacin with the hammer pounding in the cartoon head? Anacin was the most famous “APC-style” brand (though it eventually dropped the phenacetin). The whole marketing angle was that it worked “faster” because of the caffeine kick.

Empirin

Empirin was always a part of the medicine cabinet when I was a kid. For some unexplained reason, the pills were off-limits to us kids. Instead, they gave us St. Joseph’s Baby Aspirin, so we could get Reye’s Syndrome and stomach ulcers. But Empirin was a serious headache remedy for adults, and yes, it was indeed Aspirin, Phenacetin, and Caffeine. It also came in a version called Empirin #3, which added codeine for post-op pain relief.

Bufferin

Introduced in 1948 (just a few years before Tylenol hit the scene), Bufferin was the industry’s answer to the biggest complaint about aspirin: it eats your stomach lining. Pure aspirin is an acid (acetylsalicylic acid). If you take enough of it on an empty stomach, it’s like dropping a slow-release acid tab into your gut. Bufferin solved this by adding “buffers”—usually magnesium carbonate and aluminum glycinate (basically antacids).

The TV commercials usually featured a diagram of a stomach and a “race” between a plain aspirin tablet and a Bufferin tablet. While the “twice as fast” claim was a bit of a marketing stretch, the science of the “buffer” was sound.

Excedrin

Excedrin was the “Extra Strength” king, and one of the few survivors of the APC era. It did so by swapping the “P” for another “A” — Aspirin, Acetaminophen, and Caffeine. Still around today, and still relieving headaches the old fashioned APC way!

BC Powder

We mentioned this in our discussion, so I’ll add it for full coverage. BC Powder is Aspirin plus Caffeine, so “AC”, with no “P”. No acetaminophen, either. The claim was that because it lacks the pill coating, it hits the bloodstream faster. It’s still a cult favorite in the American South and among long-haul truckers.

If I missed any of these great remedies, please let me know.

Bonus Topic: Caffeine

While we think of “Tylenol” as the modern, safe choice, the caffeine in those old APCs and BC powders actually made the pain relief 40% more effective.

The caffeine doesn’t just wake you up; it changes the pH in the stomach to help the aspirin dissolve faster and constricts the dilated blood vessels in the brain that cause headaches. That’s why Excedrin Migraine today is almost identical to the formula I remember from my youth—they just swapped the toxic Phenacetin for Acetaminophen.

Ending It All in the UK

I posited that the combination of an overdose of acetaminophen accompanied by a surfeit of alcohol is the most popular route to self-elimination in the UK. Jenny countered that it while I “might be right”, it is a horrible way to go. It turns out that we’re both spot-on, as the Brits would say.

Indeed, while acetaminophen (paracetamol) figures into many self-harm incidents because it is so widely available, it is also one of the most grueling ways to go.

The Reality of the Process

The primary reason it isn’t “quick or painless” is the biological mechanism of the drug. It doesn’t switch the body off like a light; it causes a progressive, metabolic failure.

• The “False Recovery”: After an initial period of nausea or vomiting, people often feel better for a day or two. This is deceptive. During this time, the liver’s glutathione stores deplete, and a toxic metabolite (NAPQI) begins destroying liver cells.
• The Physical Toll: Once liver failure fully sets in, the symptoms are agonizing. This includes intense abdominal pain, jaundice (turning yellow), internal bleeding, brain swelling (encephalopathy), and eventually multi-organ failure.
• The Timeline: This process usually takes 3 to 7 days. It is rarely instantaneous.

Why is it a “Crowd Favorite”?

Why is it so popular if it sucks as a way to go? The grim reality is that its “popularity” isn’t due to efficacy or comfort; it’s due to accessibility.

The earlier favored method involved “Town Gas”. When the UK switched from toxic coal gas to non-toxic natural gas in the 1960s, suicide rates plummeted because the “easy” method vanished. Natural gas works, but by slow asphyxiation, not systemic toxicity, so it is far from foolproof. The convenience factor turned the tide away from cooking gas and toward readily available pharmaceuticals.

In the UK, paracetamol is in almost every kitchen cabinet. Most people choosing this route aren’t looking for a “high-quality” method—they are reaching for the tool that is closest at hand during a moment of crisis. This is actually why the UK implemented “blister pack” laws (limiting how many pills you can buy at once and making them harder to pop out), which successfully lowered the death rate by creating a “speed bump” for impulsive decisions.

The Alcohol Factor

Adding alcohol doesn’t typically make the process faster or more “painless”. It usually just accelerates the liver damage and makes the person more likely to vomit the medication back up before it is fully absorbed, often leading to permanent organ damage rather than a quick end.

Conclusion

So what did we learn from this little stroll through the analgesic archives?

First, Tylenol is not some modern pharmaceutical interloper foisted upon us by late-stage capitalism. The molecule predates automobiles, antibiotics, and the forward pass. It was synthesized in the 19th century, ignored because of a dubious paper, resurrected by NIH pharmacologists, and finally marketed into ubiquity in the 1950s. In other words, it survived the Victorian era, German skepticism, and mid-century marketing wars.

Second, many of the “good old days” headache remedies were chemical shotgun blasts: aspirin for pain, phenacetin for mystery toxicity, and caffeine for a little extra punch. The phenacetin era quietly created kidney failure and bladder cancer in the background while everyone blamed “getting older.” When phenacetin was eliminated, acetaminophen stepped into the slot as the safer metabolic endpoint of the same pathway. Progress sometimes looks less like genius and more like removing the worst ingredient.

Third, acetaminophen’s reputation for safety is conditional, not absolute. In therapeutic doses, it is remarkably gentle on the stomach and avoids the platelet and ulcer issues that plague aspirin. In overdose, it is a slow biochemical catastrophe measured in depleted glutathione, rising transaminases, and days of misery. The very mechanism that makes it well tolerated at normal doses makes it devastating when abused.

And finally, its “popularity” in the UK as a method for self-harm says more about accessibility than about pharmacologic elegance. When lethal coal gas disappeared, people reached for what was in the cupboard. Policy makers eventually responded with blister packs, proving once again that engineering friction into a system can save lives—this time, deliberately.

Victorian Vindication

So there you have it. A Victorian molecule with a mid-century brand name that replaced a toxic predecessor, outlived its critics, and now sits in nearly every medicine cabinet on Earth. Neither glamorous nor perfect; just chemically competent.

And yes, Jenny and Aliya, if someone’s mother took Tylenol while pregnant, the timeline says she was in very crowded company.

The post A Brief History of Tylenol appeared first on The Nittany Turkey.

Our Department of Health and Human Services is accumulating entropy at a pace unseen since the Second Law of Thermodynamics was astoundingly revealed by Lord Kelvin. There’s so much wasted heat in that operation that I could make this a very long feature article, but I was too disgusted by the politicization of our health to spend any more time than necessary with this.

Because politics is all about bullshit, what better a place than Bullshit Corner for this article?

Once again, we watch our friends in Washington bungle something. This one hits home more than others, for never let it be said that the American voter cares about anything more than the combined health of their body and their wallet.

Get your shovel ready!

Peptide Purgatory, published more or less weekly (or whenever I feel like writing), is a wholly owned subsidiary of The Nittany Turkey. It mixes one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity with a veritable plethora of opinions on the subject. Side effects may include sarcasm, elevated skepticism, and mild tachycardia. Ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: The FDA, HHS, and Your Vote, Thank You! appeared first on The Nittany Turkey.

If you’ve been following my saga, you’ll recall that I scheduled a DEXA body composition scan as part of my post–hernia-repair rebuild. Curiosity was certainly a factor, but the real objective was to establish a baseline for strength recovery and to quantify the alleged sarcopenia that is supposed to be quietly stealing my muscle mass while I sleep.

In a prior post, I mocked DexaFit’s marketing hype and predicted a boiler-room sales experience involving twelve easy payments and a laminated “optimization” roadmap. I am pleased to report that my cynicism, while generally well-earned, was misplaced this time.

The Ritual

The pre-scan instructions were straightforward:

• Avoid calcium the day before (no multivitamin heroics).
• Hydrate normally.
• No heavy exercise.
• Fast two hours before the 10:00 AM appointment.
• Wear workout clothes with no metal.
• and please wear socks.

I never did determine the clinical significance of socks. Perhaps bare feet disrupt the Earth’s magnetic field. Or maybe they just don’t want to look at 79-year-old toes before coffee.

I arrived on time—an increasingly radical act in modern society. The small building houses two practices. I got the bubbly receptionist. The other desk was staffed by someone who looked like she had just finished reading Dante’s Inferno as attempted hangover recovery therapy. Fortune smiled upon me.

Technologist Ken escorted me into what I will call the scanatorium. Small room. Standard GE DEXA unit. No incense. No chanting. No motivational wall decals. But the small table contained an array of skin creams, emollients, and other stuff that might appease female scanees. I never got a straight answer about why they were there. Maybe a side-hustle for Ken. Who knows?

Easy Peasy

Just why they insist on socks, I don’t know, but I wanted to be compliant. I hope my choice was suitably entertaining, albeit out of season!

I lay down. Ken adjusted my limbs to some optimal geometry. Six minutes later, it was over. Painless—unless the ionizing radiation decides to express its gratitude in 2036.

Results were instantaneous. I braced for the upsell. It came only mildly, frustrating my pre-prepared deflection. The people were actually nice.

On the way out, Ashley offered to schedule a three-month follow-up. I declined. No pushback. She handed me a 10% discount card “in case there isn’t a sale then.”

I was on the road by 10:30. No pressure. No subscription pitch. I will publicly retract my earlier insinuations of predatory capitalism. This time, anyway.

---

The Numbers: Prepare for Vanity Inflation

Biological Age: 68

Chronological age: 79.2.

According to the app, I have reversed time by eleven years. Jenny’s response: “Great. Soon you’ll be younger than me.” I did rob the cradle; convergence from both directions seems efficient.

Let’s be clear: “biological age” is marketing bullshit. But it is flattering marketing, and I am not immune to flattery. Just don’t press your luck when big bucks enter the picture.

---

Body Fat: 19%

That puts me roughly 12% lower than the average 3905 Century Club member, though admittedly we are not a cohort known for visible abs.

The app suggests a target of 13%. I suspect DexaFit has a program for that. Good for them. I do not.

At 79, 19% body fat with preserved lean mass is not a problem. It is a strategic asset. I am not chasing 13% just to satisfy an algorithm trained on 32-year-old triathletes.

---

Visceral Fat: 1.93 lb

Marked “Needs Focus” in their color-coded universe.

Let’s apply reason.

My liver MRI shows no fatty infiltration, my glycemic control is solid, and my inflammatory markers are unremarkable. A visceral fat mass under two pounds is not an emergency requiring a weighted vest crusade.

Could I shave a pound? Probably. Will I reorganize my life around it? No. But now that I’m back to working out 5-6 days per week, stay tuned to this space in about 12 weeks for the follow-up results. I might even be able to get there.

---

Lean Mass: 137 lb

Seventy-six percent of total mass. Nine percent above peer group.

Trunk lean mass: 74 lb. Thirteen percent above peers.

This is relevant if Jenny ever decides to disassemble me and transport me in luggage. It indicates that she will need to increase her Romanian deadlift numbers to manage my trunk in the trunk.

More seriously: that trunk mass supports posture, breathing mechanics, and load transmission. It is not decorative.

My goal is not to inflate this number recklessly. It is to preserve it while strength returns to pre-hernia levels.

---

Bones: Reinforced Concrete Edition

Overall T-score: +3.2
Z-score: +4.0

That places me several standard deviations above the mean in bone mineral density.

For non-statisticians, that is rare territory: lots of “nines” in the percentiles. For structural engineers, it means I am essentially constructed from concrete reinforced with steel rebar.

But wait, there’s more. It involves Bone Mass Density (BMD), overall, and in my head.

Total body BMD: 1.53 g/cm².
Head BMD: 3.06 g/cm².

Everyone has long suspected I am thick-headed. Now there is imaging proof.

I’ll give you proof — in the head already I’ll give you!

---

The Infrastructure Metrics: ALMI and FFMI

Here is where the meat meets the math.

ALMI: 8.5 kg/m²

Appendicular Lean Mass Index (ALMI) measures muscle mass in the arms and legs relative to height. It is one of the primary mass-based screens for sarcopenia.

Common cutoffs for men hover around 7.0 kg/m².

I am at 8.5.

That is comfortably above diagnostic thresholds and lands at roughly the 75th percentile for my age cohort. In plain English: my limbs are not wasting away.

If I am ever labeled sarcopenic, it will not be on the basis of mass.

---

FFMI: 22.8 kg/m²

Fat-Free Mass Index (FFMI) includes all non-fat tissue—muscle, bone, organs, water.

For men:

• 18–20: average
• 21–23: trained
• 24+: genetically gifted or pharmacologically ambitious

At 22.8, at 79, after an eight-week surgical layoff, I am solidly in trained territory.

That number matters more to me than “biological age.” Jenny has me trained well.

---

BMI vs. Reality

For comic relief, my calculated BMI is 28.2.

Translation: “Overweight.”

BMI cannot distinguish between:

• muscle
• bone
• water
• fat

If I removed ten pounds of muscle and added ten pounds of fat, BMI would not change at all. That should end the discussion. BMI, stupid. DEXA, moderately intelligent.

---

So What Does This All Mean?

It means:

• I am not mass-defined sarcopenic.
• My visceral fat is low.
• My bones are annoyingly dense.
• My lean mass is preserved.
• My post-hernia rebuild has a solid structural foundation.

The real risk at my age is not lack of muscle. It is overzealous fat loss chasing aesthetic targets and sacrificing lean mass in the process.

Nineteen percent body fat with ALMI 8.5 and FFMI 22.8 is a balanced operating point. The mission now is simple:

• Restore strength.
• Maintain lean mass.
• Avoid stupid caloric deficits.
• Ignore vanity metrics.
• Re-scan in 12–16 weeks under identical conditions.

And yes, I did receive a small dose of X-rays.

If I keel over from radiation poisoning, at least I’ll do so with a biological age of 68 and a skull denser than most bridge abutments.

Not a bad way to go.

Bringing It Home

So what does all this mean when you strip away the color-coded dashboards, percentile badges, and AI-generated flattery?

It means this:

At 79, fresh off hernia repair and an eight-week layoff from real loading, I am carrying:

• Preserved appendicular muscle mass (ALMI 8.5),
• Trained-range fat-free mass (FFMI 22.8),
• Low visceral fat,
• Reinforced-concrete bones,
• And a perfectly ordinary male-pattern A/G ratio.

In other words, the chassis is intact.

There is no sarcopenic emergency to reverse, no metabolic fire to extinguish, and no urgent need to chase 13% body fat just because an app flashes it in green.

What there is, however, is opportunity.

The DEXA scan didn’t reveal a problem. It revealed a starting line.

From here, the mission is straightforward:

• Rebuild strength methodically.
• Maintain or modestly improve lean mass.
• Keep protein intake appropriate.
• Avoid reckless fat-loss theatrics.
• Re-scan in 12–16 weeks under identical conditions.

If the numbers improve, excellent. If they remain stable while strength climbs, that’s still success. Stability at 79 is not stagnation; it is preservation of capacity.

The irony is that I walked into DexaFit half-expecting to confirm decline.

Instead, I walked out reassured that I am structurally ahead of where many of my peers already are—and with objective data to defend that claim.

The scan did not make me younger. But it did make me clearer.

And clarity, at this stage of life, is worth more than a few vanity percentage points.

Now if you’ll excuse me, I have a trap bar waiting in what used to be the family room.

Peptide Purgatory, published more or less weekly, is a wholly owned subsidiary of The Nittany Turkey. It mixes one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity with a veritable plethora of opinions on the subject. Side effects may include sarcasm, elevated skepticism, and mild tachycardia. Ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post DexaFit: Suddenly, I Feel 68 Again! appeared first on The Nittany Turkey.

My chronic gout provides an opportunity to shift from incretins to blast drug pricing in another area: rheumatology. During a recent visit with my podiatrist, she recommended Kristexxa, but did not forewarn me about sticker shock that would make my head explode. I’ll give you the lowdown on Kristexxa, including a humorous aside on how it might have changed history had it been available for Henry VIII, Napoleon Bonaparte, and Diamond Jim Brady.

Finally, Bullshit Corner examines the latest important grant-funded clipboard research from the University of Delaware, which seeks to examine the connection between marijuana use and blood pressure in “understudied” inner-city populations witnessing violent crimes. No, I’m not making this up!

When the Miracle Drug Meets the Price Guillotine

For a brief, shining moment, Big Pharma thought it had done it again.

GLP-1 drugs were not just blockbusters. They were category annihilators. Obesity, diabetes, cardiovascular risk, maybe half the contents of an internal medicine textbook, all bundled neatly into a once-weekly injection with a pleasant side effect of making insurers cry softly into their spreadsheets. Then reality showed up, carrying a calculator.

According to reporting by the Wall Street Journal, the price war now breaking out among weight-loss drugs is doing something that used to be unthinkable: it is actively undermining the traditional pharmaceutical business model. List prices north of $1,000 per month were tolerable when demand exceeded supply and competition was theoretical. That phase is ending — fast.

Too Many Needles, Not Enough Wallets

Manufacturers like Novo Nordisk and Eli Lilly are discovering an inconvenient truth that engineers already know: scaling exposes weaknesses.

Yes, tens of millions of Americans technically qualify for GLP-1 therapy. No, insurers are not going to pay $12,000 a year for all of them. Employers are already pushing back. Medicare is circling the issue like a vulture with a spreadsheet. Medicaid is mostly laughing.

The result is what the Journal delicately calls “pricing pressure,” which is corporate journalism for margin compression with screaming. Discounts, rebates, direct-to-consumer pricing experiments, and quiet negotiations are replacing the old model of set a price, defend it with a PowerPoint, and dare anyone to blink.

This represents a structural shift, not a temporary price hiccup.

Enter the Politicians, Stage Left: trumprX

Big Pharma discovering the power of arithmetic is one thing, but big numbers, not advanced math, will always attract political opportunists like flies to a steaming pile of offal. Enter TheDonald.

The second WSJ piece describes the resurrection of a Trump-branded drug pricing website, TrumpRx, framed as a populist strike against high prescription costs. It is vintage Donald Trump: aggressive rhetoric, simplified villains, and an implied promise that something will be cheaper soon, details TBD. You just wait and see. We’ll have the most fantastic prices ever!

The timing is not accidental. GLP-1 drugs are now famous enough to be politically useful. They are expensive, visible, and emotionally loaded. That makes them perfect props in a broader narrative about greedy companies, helpless patients, and strong leadership riding in on a white horse holding a discount card. Pure populist exploitation at its finest.

Whether the site actually changes pricing is almost beside the point. The real effect is pressure. Political scrutiny accelerates insurer resistance, emboldens regulators, and gives cover to employers who want out of unlimited coverage commitments. Big Pharma executives understand this dynamic very well, even if they pretend otherwise on earnings calls.

The Collision Course: dEATH BY A tHOUSAND cUTS

Put the two WSJ stories together and the picture sharpens:

• Demand is massive but not monetizable at current prices.
• Competition is real and accelerating.
• Payers are done being dazzled by novelty.
• Politicians smell blood in the water.

This is how a pricing regime collapses. Not overnight, not with a single regulation, but through a thousand small concessions that never quite get walked back.

GLP-1s are not going away. They work too well for that. But the era of treating them like rare oncology biologics rather than chronic-use metabolic drugs is ending. Chronic drugs eventually get priced like chronic drugs. History is boring that way.

Peptide Purgatory Takeaway

For patients, this is cautiously good news. Prices that come down are prices that get covered. Coverage that expands is access. Access beats miracle drugs that live only on CNBC graphics.

For Big Pharma, this is the hangover phase. The part after the champagne where someone asks how the math works long-term.

And for the rest of us watching this unfold, it is a reminder that even the most elegant molecule eventually has to survive contact with economics, politics, and human nature.

Krystexxa — When Gout Therapy Meets Sticker Shock

So there I am, whining about friction on top of the left foot, and Dr. Toebender pokes around and finds a tophus the size of a small pebble. Classic refractory gout stuff. I tell her allopurinol is already queued up once I’m off the hernia treadmill, and she hands me a brochure for Krystexxa infusions with the same enthusiasm most of us reserve for handing out slices of birthday cake.

Then I googled the price. Oy, vey! According to price guides, an 8 mg vial of Krystexxa can run roughly $30,000 per infusion. For one vial. One. Basic math suggests that if you need these every couple of weeks — as some regimens do — list cost for a year can push toward $700,000 or more. Marty, my CPA, is recoiling in horror, and I haven’t even consulted him on this yet.

Allopurinol costs pennies and is covered under just about all forms of insurance, government or otherwise. As for Krystexxa, if you meet stringent criteria, your Uncle Sam technically might cover some of the cost under Medicare Part B, but you still can be on the hook for 20%, and plans differ wildly on what they’ll actually pay.

What’s more, support programs aimed at making Krystexxa “affordable” are usually structured to exclude government-funded coverage — meaning if Medicare or Medicaid is pulling the trigger, the co-pay card doesn’t apply. That juxtaposition, when you think about it, says a lot about who’s really paying for what in American drug pricing.

In the world of Peptide Purgatory, this is Exhibit A for how we went from cheap dietary control and cheap allopurinol to biologics that cost more than a teacher’s salary. Yes, Krystexxa has its place for patients who can’t tolerate or respond to classical therapy, but its pricing is also a powerful reminder that every “miracle” drug exists in a marketplace built around maximizing revenue, not minimizing suffering.

Sidebar: If History’s Most Famous Gout Sufferers Had Krystexxa

Gout has always punched above its weight in history. It is the disease of kings, emperors, and men who mistook excess for destiny. Which raises an important counterfactual question:

What if they’d had Krystexxa?

Henry VIII

Henry VIII didn’t lose mobility because he lacked motivation. He lost it because his joints were filling up with crystallized uric acid while he ate like a Tudor Costco sample aisle. With Krystexxa infusions at roughly $30,000 a pop, Henry might have stayed mobile enough to keep jousting, hunting, and marrying.

Of course, the English treasury would have collapsed by wife number three, Parliament would have revolted earlier, and the Reformation might have been delayed by a prior authorization request.

Napoleon Bonaparte

Napoleon’s gout famously flared during the Waterloo campaign. Historians like to debate tactics, weather, and logistics. They rarely ask the obvious question: what if the man could put on his boots without screaming?

A timely infusion schedule could have altered European history. Or not. Given the cost, France might have had to sell Corsica twice.

Diamond Jim Brady

Diamond Jim treated gout as an occupational hazard of eating twelve entrees before lunch. Krystexxa would have been perfect for him. Unlimited appetite, unlimited infusions, unlimited billing.

In his case, the drug would not have prevented excess. It would have enabled it. Which, frankly, is very on-brand for modern specialty pharmaceuticals.

The Takeaway

Allopurinol works.
Diet helps.
Both are cheap.

Krystexxa exists for severe, refractory cases, and that is fair enough. But when a centuries-old disease with effective low-cost management suddenly acquires a therapy priced like a Gulfstream lease, you begin to wonder whether we are treating pathology… or monetizing it.

Henry VIII lost his kingdom’s solvency without biologics.
Napoleon lost Europe without them.
Diamond Jim lost his joints joyfully.

Today, the only thing that really loses is the payer.

Progress, apparently, comes with an infusion chair and an invoice thick enough to require two hands.

See You Next Week!

That steaming pile of bullshit wraps up yet another week of Peptide Purgatory. Stay tuned to this channel for next week, in which I will report in detail the findings of Wednesday’s DEXA scan body composition analysis and associated sales pitch for ongoing services at DexaFit.

Peptide Purgatory, published more or less weekly (whenever I feel like it), mixes one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity with a veritable plethora of opinions on the subject. Side effects may include sarcasm, elevated skepticism, and mild tachycardia. Ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: GLP-1 Price Wars, Gout, and Weed appeared first on The Nittany Turkey.

Readers who followed my recent exploration of organizational entropy may recognize the metaphor I’m about to reuse, now applied to concierge medicine. Dr. DeLorean must once again make an appearance in the Nittany Turkey after I swore off ever mentioning him here again. The guy just keeps returning like a bout of indigestion following a bad bowl of spaghetti and meatballs.

Recall that after sufficient, repeated provocation I finally dumped DeLorean last September. Although I’m happily done with him, I am now learning of issues with other patients that strike a familiar chord. Several similar stories have surfaced, one of which will be the focus of today’s Peptide Purgatory.

A Case in Point

Another septuagenarian whom I’ll call JB, a friend of mine who I had referred to DeLorean back in 2019, was recently “fired” by the concierge practice – for insubordination! If he didn’t have a serious, chronic condition, the situation would be laughable, but because he does, the summary action borders on medical irresponsibility. So, let’s get this straight. He pays $3,600 per year for what? Apathetic care?  Poor communication? Then, worse yet, dare to question the doc or his staff and get the heave-ho for impertinence?

My friend’s complex diagnosis requires close monitoring, coordination with specialists, and constructive collaboration. What he received from the high-priced DeLorean concierge operation in posh quarters in the high-rent district was akin to what one would expect from a high-volume, urban storefront clinic – with the added ignominy of summarily dumping a patient with complex needs.

Thus, this concierge practice appears to have progressed through the same stages of organizational entropy that plague ham radio award nets, a subject I have covered extensively here. What begins as a focused, functional concept eventually turns inward, prioritizing stability and self-preservation over its original mission. Complexity becomes noise. Questioning becomes disruption. Entropy sets in, and in the end, it always wins.

Let’s take a jaundiced-eyed, Nittany Turkey look at the progression toward increasing entropy in the life-cycle of a concierge medicine practice.

Earnest Beginnings: Low Entropy, High Intent

When I first signed on with Dr. DeLorean in 2017, he presented as a sincere and engaged physician who wanted to provide highly personalized care to patients with above-average expectations. At the time, that description fit.

Several features reinforced my sense that I had made a sound decision. He was willing to collaborate on chronic conditions that had been mishandled elsewhere and, notably, he went beyond the usual concierge pitch. He contracted with outside imaging providers who came directly to his office, sparing patients the usual logistical friction. His small staff was responsive and effective at coordinating appointments in the surrounding medical community. He read medical journals and shared articles of interest with patients. This was what concierge medicine was supposed to look like.

The practice’s annual fee then was $2,700, and it felt justified. Two years later, my assessment hadn’t changed, and I referred JB to the practice. He, too, was impressed. I would later regret having done so, but like mine, his early relationship was replete with optimistic promise — a breath of fresh air, even.

By that point, however, the practice was already beginning to shift. A new, expansive office was designed and built, and the center of gravity subtly changed. The practice itself began to consume more attention and energy, while patients gradually became necessary inconveniences rather than the organizing principle.

Steady State with Entropy Creep

From my perspective, the decline accelerated around the time the new office opened. The COVID pandemic then forced the practice into a kind of artificial equilibrium. Expectations dropped everywhere, and the pandemic became a convenient universal excuse. Even in Florida, where restrictions were comparatively light, COVID provided cover for lapses that might otherwise have been harder to explain.

As the pandemic eased, staffing increased. DeLorean spoke openly about expanding the practice and bringing in an associate physician to give himself some breathing room. The first step in that direction was hiring a nurse practitioner, euphemistically referred to these days as a “physician extender.”

Around this time, I began to notice a change in engagement. During a road trip, I developed a serious gastrointestinal issue that resulted in a sleepless night in an out-of-state emergency room. My supposedly “always available” concierge physician was unavailable. When I finally heard from him the next morning, he congratulated me for going to the ER. A follow-up? None suggested, but I insisted, so he reluctantly told me I could call the office when I returned home. No offers to have the staff coordinate care with the gastroenterologist. I was on my own.

The More, the Merrier

Meanwhile, the staff continued to grow. This was a cash-only practice. No need to handle insurance billing, no armies of clerks required to appease government or third-party payers. Aside from a billing manager, a receptionist, and a small clinical staff to room patients, take vitals, and draw blood, it was never clear what problem the growing bureaucracy was solving. From personal experience, it sure as hell wasn’t patient communication!

Serving the intent of expanding the practice, an additional physician was brought on briefly and departed within months. The expansion plan stalled. What did not stall was entropy. Errors increased. Communication became even more diffuse, with “ask the doctor” requests fielded by nameless operatives shielded by an antiquated and barely functional “patient portal”. Terse responses starting with “he said” were the norm. Specialist visits were acknowledged but rarely integrated into care.

The Notorious Vogue Diagnosis

One moment crystallized the shift. As I’ve often reported here, my gastroenterologist, The Irascible Dr. Scrooge, diagnosed me with IPMNs, a known pre-cancerous pancreatic condition. DeLorean waved it off with a laugh as “the latest vogue diagnosis,” deferring responsibility entirely to Dr. Scrooge. “We’ll leave that to him,” he stated. At that point, I was paying $3,500 per year and effectively coordinating my own care.

I asked myself what in the hell I was paying for. Care coordination I wasn’t getting? I was left on my own to make appointments with specialists and imaging facilities. It sure as hell wasn’t strong communication, either. As I mentioned, I only received second-hand transcriptions of passing, cursory comments by the doc through the crappy patient portal. Lastly, based on another of DeLorean’s now-famous remarks, “I can’t keep track of all your chronic conditions,” it obviously wasn’t long-term holistic oversight.

Was I paying for nothing more than the prestige of membership in an exclusive clientele?

The Disengagement

A subsequent urinary tract infection, later identified as Serratia marcescens, further exposed the system’s fragility. A prescription was mishandled. Still in pain, suffering from the infection that festered for an additional ten days after not responding to shotgun treatment, I called to have the error corrected. After scratching their collective heads for ten minutes while I grew increasingly impatient, the staff could not explain what had happened. I was in no mood for incompetence.

When I pressed, DeLorean himself called, irritated over my questioning his staff. Mistakes happen, he said, and I should accept that. He then informed me that I was not a good fit for his practice and suggested I look elsewhere once the acute issue was resolved.

The doc later walked that back, but the message was clear. He was right. I did not fit his mold: a docile patient who follows orders, tolerates sloppy errors, and questions nothing. My tolerance reached its limit. Thus, I did, in fact, begin to look elsewhere, and six months later I left on my own terms.

Current Phase: Entropy Dominance

I mentioned above that I had referred my friend to DeLorean back around 2019. JB is an engineer. He asks questions, expects clarity, and has little tolerance for incompetence. Until recently, he had been in good health, but as tends to happen in one’s seventies, complexity increased. As it did, DeLorean’s engagement receded.

When JB’s needs peaked, the practice disengaged.

After a recent fall that resulted in a lacerated chin, JB went to the emergency room, had the wound sutured, and was discharged with instructions to follow up with his primary care physician. When he called DeLorean’s office the next morning, he was routed to the nurse practitioner and told, flatly, that he could not be seen that day. No explanation. Just no.

A Complex Diagnosis

JB carries a diagnosis of cerebral amyloid angiopathy (CAA), a condition that requires careful monitoring and rigorous blood pressure control. He believed this was precisely what he was paying $3,600 per year to receive. $3,600? Yeah, DeLorean must have raised his fees yet again after I departed.

In January, JB had a routine appointment. Two weeks later, he received an email from the same nurse practitioner stating that, due to his “push back and questioning” of the physician’s opinion, DeLorean no longer felt there was a “respected physician-patient relationship.” His membership was terminated effective immediately. There was no mention of refunding unearned fees.

The method was familiar. Difficult conversations handled by proxies. Risk managed by disengagement.

Increasing Entropy in a Closed System

At this stage, the system exists primarily to preserve itself. Anything that introduces disorder is rejected. In this context of late-stage concierge medicine, that means shedding patients with:

• rare diagnoses
• longitudinal risk
• inconvenient questions
• adverse outcomes waiting in the wings

Entropy management becomes the primary function. Not care or outcomes, but stability, predictability, and low noise.

CAA. IPMNs. Resistant infections. Falls. Seizures. Uncontrolled hypertension. These are all high-entropy inputs. They demand thought, coordination, documentation, and ownership. A brittle system responds the only way it can: by ejecting the source of disorder.

Healthy patients are welcome. Minor ailments are fine. Chronic complexity is not. Questions? Out of the proverbial question!

That is why the language shifts from medicine to “relationship.” Why access evaporates when tested. And why patients are fired instead of managed.

In thermodynamic terms, DeLorean’s practice is a closed system pretending to be open. It markets itself as adaptive and patient-centered, but it lacks the energy, humility, and accountability required to sustain that claim. Entropy wins.

It always does.

Marketing Promises vs. Operational Reality

The practice’s public materials present a familiar concierge narrative: the attention you deserve, the health care you want, and timely, unhurried office visits, supplemented by telephone or electronic consultations and even home visits, all ostensibly arranged around the patient’s schedule. The messaging emphasizes individualized care, advocacy through a complicated health care system, and expanded services delivered in a comfortable, well-appointed environment. The branding is polished and reassuring, projecting accessibility, continuity, and thoughtful coordination.

Yet this aspirational language sits uneasily beside patient experiences marked by denied follow-ups, dismissive responses to specialist diagnoses, and abrupt terminations of long-standing relationships. When concierge medicine markets itself on access and personalization but operationally limits availability and disengages when complexity arises, the discrepancy between promise and performance becomes difficult to ignore. At that point, the concierge label functions more as a marketing gadget than a reliable description of care delivery.

Entropy in Action: From Responsiveness to Self-Preservation

Viewed through a systems lens, the practice’s marketing artifacts exhibit the early hallmarks of a low-entropy organization: clear intent, focused purpose, and a design oriented toward patient experience. Over time, however, entropy exerts its usual pressure. Without continuous investment in engagement, coordination, and accountability, systems drift toward self-preservation.

In early phases, expanded services and physical growth appear aligned with the concierge ideal. In later phases, priorities subtly shift. The system becomes less tolerant of disorder. Complexity is no longer managed; it is avoided. High-entropy inputs — rare diagnoses, longitudinal risk, inconvenient questions, and the prospect of adverse outcomes — are increasingly treated as destabilizing forces rather than clinical responsibilities.

The public language remains aspirational: individualized care, timely access, advocacy. But the operational response suggests a different organizing principle. The system now seeks equilibrium by reducing noise, insulating itself from uncertainty, and minimizing exposure to cases that demand sustained attention. In thermodynamic terms, this is a closed system presenting itself as open. The marketing remains static while the operational reality adapts toward internal stability rather than patient-centered outcomes.

Entropy, unmanaged, does what it always does.

Closing the Loop: Entropy Is Not Selective

Readers of The Nittany Turkey are aware of my obsession with systems characterizations of organizations. My series on entropy in ham radio award nets and the lighthouse allegory were the initial forays into the area. However, the model applies across a broad spectrum of organizations. Provided sufficient provocation of late, I decided to analyze concierge medicine through the now familiar systems lens.

In ham radio nets, what begins as a focused, mission-driven system with motivated operators and clear purpose gradually accumulates friction. Participation grows, rules harden, procedures multiply, and eventually the system exists less to serve its original goal than to protect itself from disruption. Awkward check-ins are discouraged. Slow operators are sidelined. The net becomes orderly, predictable, and increasingly hollow.

A Promise to Die For

Concierge medicine appears vulnerable to the same lifecycle. When complexity is embraced, the system remains adaptive and valuable. When complexity is treated as noise, the system turns inward, prioritizing stability over service. In both cases, entropy does not signal malice or incompetence. It signals neglect. Systems that fail to continually invest energy in their original mission do not collapse spectacularly. They simply stop doing what they were created to do, while insisting, often quite sincerely, that nothing has changed.

Engineers recognize this failure mode instinctively: when feedback is suppressed, disturbances are rejected rather than damped, and the system is tuned for internal comfort instead of external performance, it may appear stable — right up until it no longer serves its function at all.

Peptide Purgatory, published more or less weekly (whenever I feel like it), mixes one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity with a veritable plethora of opinions on the subject. Side effects may include sarcasm, elevated skepticism, and mild tachycardia. Ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: Entropy in Concierge Medicine appeared first on The Nittany Turkey.

My good friend and 3905 Century Club colleague Dwight Greenberg, WF4H, passed away at age 75 on Wednesday, December 10, 2025, at his home in Hughes Springs, Texas, following complications from open-heart surgery. Dwight had lived for many years in Cocoa, Florida, just an hour from my home, which made it easy to work together and, just as important, to sit down occasionally and shoot the breeze. Two months have now passed since his death. I still miss Dwight’s hearty laugh and his loyal friendship.

I want to remember this larger-than-life character and share a few memories with those who knew him, and perhaps with others who wish they had.

The Call

Dwight called me the day before he died and left a voicemail. He was home from the hospital and wanted to catch up. The timing, cruelly, couldn’t have been worse. At the moment he called, I was undergoing hernia repair surgery.

The next day, while sitting in my recliner recovering, the phone rang. Seeing Dwight’s number, I answered cheerfully, “Hiya, SICKO!!” Instead, it was his wife of 56 years, Beth. Before she said anything more than, “Ben, this is Beth…,” I knew. My heart sank as she continued, “…Dwight passed away this morning.”

I immediately regretted my boisterous greeting and told her how sorry I was. Beth, stalwart even in her grief, gently reassured me. “You didn’t know,” she said.

Before we ended the call, she asked me to take care of club matters. More on that later.

The Man

Who was Dwight Greenberg?

First and foremost, he was a family man. Dwight and Beth had recently celebrated 56 years of marriage. They have a daughter, Heather, a son-in-law, Arlen, and a granddaughter, Lindsey. Dwight served in the U.S. Air Force for 21 years, retiring in 1989 as a Master Sergeant. After his military career, he spent 25 years working for Harris L3 Corporation.

Dwight and Beth also shared a passion for exotic birds, raising them for many years. Dwight held numerous leadership positions with the American Federation of Aviculture, including Florida Regional Director, Southeastern Regional Director, First Vice President, Secretary, and Chairman of the Florida Federation of Avian Societies.

Another shared interest was lighthouses. Together, they visited more than three hundred around the world. Dwight served as a docent with the Cape Canaveral Lighthouse Foundation, leading tours of both the lighthouse and its museum.

He also served as a net control station for the National Hurricane Watch Network, a role that placed him on the front lines during Atlantic, Caribbean, and Gulf hurricanes.

Dwight was first licensed as an amateur radio operator in 2010 as KJ4SGI. Later, he obtained the vanity call sign WF4H, which he proudly held for the rest of his life.

The Ham

Back in 1968, as a newlywed in Connecticut, Dwight admired his father-in-law’s Collins S-Line ham shack. He wanted one of his own. Life intervened. An empty wallet, military service, and the responsibilities of career and family delayed that ambition for forty years.

In 2010, the stars finally aligned. Dwight was 59½ and cashed out his IRA. Suddenly, the ham shack was within reach. He earned his Technician Class license at Orlando HamCation in February 2010, upgraded to General in April, bought his first HF rig, strung up a G5RV, and was on the air. KJ4SGI had arrived.

The Club

For those unfamiliar, the 3905 Century Club was founded in 1977 to promote on-air activity and issue awards. Dwight joined around 2010 while living in Cocoa and proudly attended every annual “Eyeball” gathering from 2011 forward. I joined a few years later and first met Dwight in person at the 2014 Eyeball in DePere, Wisconsin.

I became more deeply involved with the club that year, eventually serving as Awards Secretary and later Fourth Area Director. Dwight, meanwhile, was elected President in 2016 and served a two-year term. Afterward, he continued serving on advisory and bylaws committees. When my assistant director stepped down in 2020, I asked Dwight to take the role. I was honored when he accepted.

Sadly, I would ultimately be the one who broke the sad news to the Club that one of its leading members had passed away. I informed the President and made the announcement to the members via the on-line forum. Later that night, the nets would pay tribute to Dwight as a “silent key”, checking him in for one last time.

The Master

The 3905 Century Club Master’s Degree is its pinnacle award, recognizing persistence, service, and operating courtesy. Dwight earned that distinction as Master #72 in 2020.

When I asked him what it meant, he likened it to earning an Amateur Extra license. “General is fine,” he said, “but there’s more to do.” Then he added, “Finish what you start.” And he did.

The Shootout

The Mobile Shootout had long been a feature of Eyeballs but had fallen into disarray. After I accidentally won it in 2018, Dwight decided it was time to fix it properly. Together, we rebuilt it from the ground up. After delays due to venue issues and the pandemic, the first fully realized shootout finally took place in 2021 in Louisville, Mississippi.

Dwight ran it like a seasoned Master Sergeant. It worked flawlessly. He went on to lead the event in subsequent years, and upon his passing, I felt it was time to step aside and let others carry it forward.

The Eyeballs

Dwight was the life of every Eyeball. His cigar-fueled bull sessions were legendary. Beth often attended as well, contributing quietly and generously.

Attending the event at DePere, Wisconsin in 2014, Dwight was the 40-meter Early Net Coordinator and a frequent net control station. That net’s start time had been the subject of endless debate. Dwight resolved the issue in Wisconsin by standing before the assembled membership holding a shotgun and announcing the time was set. If anyone wished to argue, they could step forward. Laughter followed. The debate ended.

At the 2017 Eyeball in Upperco, Maryland, shortly after Dwight’s heart attack, he was outside raising antennas while the rest of us talked inside. Beth finally had enough. “Get out there and help Dwight!” she said. “None of you just had a heart attack!” We complied.

That year, we presented Dwight with a gag plaque depicting him as the eagle on the presidential seal, smoke emanating from his beak and a cigar in his talon. It hung proudly in his shack until his move to Texas.

Dwight’s final Eyeball was in Guthrie, Oklahoma, in 2025.

The Loss

Many members will miss Dwight, even if they don’t yet realize how much. His presence will be absent from Eyeballs, Zoom sessions, and late-night conversations. The club will feel quieter without him.

But Dwight lives on in our stories, our memories, and the friendships he helped forge. For those of us who knew him well, that light hasn’t gone out.

The post Remembering Dwight appeared first on The Nittany Turkey.

It was only a matter of time before the lawyers latched onto GLP-1 drugs as a profit-maker. I mean, why not? Everybody else has had his shot at it. Now the game progresses to the bureaucratic chaos phase. Read on to see what our plaintiff bar friends have up their collective sleeves.

Following the feature article on GLP-1 lawsuits, I’ll share a very British warning you you. What are they warning King Charles’ subjects about? Well, you guessed it: GLP-1s. Finally, yet another instance of Bullshit Corner disdains a vacuous study relating tap water to high blood pressure. You’re not going to want to believe that someone got grant funds for that sparkling bit of low-value observational research.

You’re already looking at the phony TV ad below, I know, so I’ll jump right in.

How the Plaintiff Bar Is Mining the GLP-1 Craze for Fun and Profit

Every gold rush has three phases.

First, someone discovers something valuable. Second, capital pours in. Third, the lawyers show up with shovels and start digging sideways.

Welcome to Phase Three of the GLP-1 era.

Drugs like Ozempic, Wegovy, Mounjaro, and Zepbound—manufactured by Novo Nordisk and Eli Lilly—have done something modern medicine almost never does: they work. Not perfectly, not without tradeoffs, but meaningfully. They lower A1c, reduce weight, and reduce cardiovascular and kidney risk. And yes, they act on the gastrointestinal tract, because that is where incretin biology lives. Amazing revelation, I know.

That was Phase One.

Phase Two: Expansion

Phase Two was predictable. Massive demand, aggressive marketing, social-media hysteria, off-label prescribing, compounded knockoffs, med spas run by people whose medical training appears to consist of a laminated badge, an Instagram account, and access to an on-line doctor in India. Money everywhere. Real money.

Then, as I wrote last week in The GLP-1 Dietary Revolution, the food, supplement, and wellness industries wasted no time slapping “GLP-1 friendly” labels on anything that would hold still long enough for a marketing photo. Protein bars, shakes, frozen meals, fiber powders, hydration potions—entire product lines suddenly discovered an intimate, lifelong relationship with incretin biology. None of this was regulated. None of it was clinically validated. All of it was monetized.

This was Phase Two: secondary capitalization. Once a therapy becomes culturally dominant, every adjacent industry shows up with a hand out. The supplement industry in particular—long accustomed to operating in the regulatory shadows—saw GLP-1 users as a captive audience with disposable income and chronic anxiety. That anxiety was then helpfully amplified by influencers, clickbait headlines, and wellness grifters warning that without the right add-ons, your expensive injectable miracle might somehow “fail.”

Phase Three: The Sharks Arrive

That atmosphere matters, because it set the stage for Phase Three. When consumers are primed to believe they are both fragile and misled, litigation becomes inevitable. The plaintiff bar never misses an major opportunity to monetize by stirring a steaming pot of deep-pocketed corporations and small guy misfortunes.

Welcome to Phase Three: the plaintiff bar smells blood in the water. And it’s going to get bloodier.

As of late January 2026, more than 3,000 lawsuits have been filed against GLP-1 manufacturers. This is no longer about a few genuinely injured patients seeking redress. This is now a full-blown mass-tort industrial operation. Intake websites, TV ads, social media funnels, and law firms that have never seen a stomach they didn’t want to paralyze—on contingency.

See You in Court: The Allegations

The legal claims follow a familiar script:

• Failure to warn,
• Deceptive marketing,
• Downplayed risks, and, of course,
• Corporate greed.

The alleged injuries cluster into three buckets:

First, severe gastrointestinal complications—gastroparesis, ileus, and prolonged vomiting. These are real conditions. They are also conditions that have always been discussed in GLP-1 labeling, physician education, and FDA reviews. The idea that slowing gastric emptying might—brace yourself—slow gastric emptying is apparently now a legal revelation.

Second, vision loss, specifically NAION, a rare ischemic optic neuropathy that ophthalmologists have been debating causality on for decades. Correlation is not causation, but correlation plus a sympathetic jury equals a settlement spreadsheet.

Third, marketing claims, alleging that weight-loss enthusiasm somehow negated decades of informed consent doctrine. Apparently, if enough people want a drug, lawyers can argue that nobody really consented to it. Wasn’t really their idea. You get it.

Far removed from good science, this amounts to narrative construction, painstakingly contrived to resonate with juries.

Enter the MDL Machine

To keep the litigation “efficient” (read: scalable), the cases have been herded into Multidistrict Litigation (MDL) in the Eastern District of Pennsylvania.

MDL 3094 handles the GI claims.
MDL 3163 handles the NAION claims.

If you’ve followed mass torts before—Roundup, Vioxx, opioids, talc, mesh—you know the playbook. Consolidate. Delay. Leak scary numbers to the press. Float hypothetical settlement ranges. Repeat until shareholders blink. Oy vey is mir!

Experts are already whispering about potential settlements ranging from $150,000 to $700,000 per plaintiff, depending on injury severity. What’s driving the numbers is not actual liability, but probabilistic jury acquiescence.

And no, the lawyers are not paid by the hour for this valuable civic service.

Expansion Pack: Everyone Gets Sued

Predictably, the litigational blast radius is growing.

Manufacturers are suing compounding pharmacies and med spas for selling “research-grade” semaglutide and tirzepatide—often sourced from god-knows-where, mixed by god-knows-who, and injected into economically-minded patients who think “USP” is a yoga pose.

Meanwhile, state attorneys general in places like Connecticut and Texas have decided this party looks fun and have piled on with their own actions, alleging kickbacks and deceptive distribution practices.

At this point, the only people not being sued are the TikTok influencers who convinced half the country that peptides are a lifestyle choice.

Give it time.

The Buchanan Moment: From Innovation to Racket

Here’s where the Buchananistic progression matters.

We started with genuine medical innovation, then moved to commercialization and excess. We have now arrived at the racket phase.

The plaintiff bar does not innovate. It neither heals nor prevents harm. It extracts value after the fact, using the legal system as a leverage multiplier. When it “wins,” patients do not get safer drugs faster. They get checks years later, minus fees. Manufacturers respond by raising prices, narrowing indications, and practicing defensive labeling that helps no one.

Who pays? Patients, insurers, taxpayers, and future patients who never get the next generation of therapies because the liability risk killed them in utero.

Big Pharma may be making money, but don’t kid yourself: the contingency-fee class wants its cut — and it always sucks out its share first.

Which brings us to the next logical step in this entropy cascade.

Phase Four: Government Sues Government

This phase is still theoretical—for now—but it is entirely consistent with how late-stage institutional decay works.

Once private-sector defendants have been bled sufficiently, attention will shift inward. Regulatory agencies, having failed to prevent confusion, overpromising, under-education, and media panic, will discover that the safest place to point the finger is sideways.

Picture it:

• The CDC releases guidance suggesting long-term population risks were underestimated.
• The FDA responds that all labeling was adequate and science-based.
• Congressional hearings ensue.
• Inspectors general sharpen knives.
• States file suit claiming federal preemption failures.
• Federal agencies counterclaim jurisdictional overreach.

At that point, the legal profession achieves peak efficiency: taxpayer-funded agencies suing each other with taxpayer-funded lawyers, while taxpayer-funded courts referee the spectacle. Money circulates. Nothing improves.

This is the mythical Phase Four, where entropy completes the loop. Innovation is long gone. Accountability is a side-show. Everyone is technically “doing something,” and no one is actually solving the problem that started it all: how to deploy powerful therapies rationally, transparently, and without turning them into cultural moral panics.

If that sounds far-fetched, recall that we already live in a world where hospitals sue insurers, insurers sue states, states sue the federal government, and the federal government sues itself via administrative law. Adding GLP-1s to that bonfire is consistency rather than escalation.

So yes, you catch my drift—and unfortunately, so does everyone else who has watched a functional system slide headlong into the racket phase.

Final Thought

Indeed, I do not deny that some patients have been harmed. They deserve care, honesty, and compensation where causality is real and proven. But what we are watching now perverts any essence of justice into opportunism.

GLP-1s didn’t create this system. They just wandered into it—effective enough to be valuable, popular enough to be profitable, and complex enough to be litigated to death. The plaintiff bar never misses such a juicy opportunity.

And Peptide Purgatory now has followed the GLP-1 morass down the fiery staircase to the Seven Rings of Legal Hell.

The British Are Very Concerned (Again)

When the UK government clears its throat, it does so politely, formally, and with a footnote. This week’s contribution comes from the Medicines and Healthcare products Regulatory Agency (MHRA), which has issued a sternly worded update reminding everyone that GLP-1 receptor agonists can, in rare cases, cause acute pancreatitis—including necrotising and fatal forms.

This announcement has already begun its transatlantic journey, stripped of nuance and inflated by social media into something resembling “GLP-1s melt your pancreas.” That is not what the MHRA said—but let’s translate this into plain English anyway.

What Actually Happened

The MHRA reviewed post-marketing safety data covering 2007 through October 2025. During that period, roughly 25.4 million packs of GLP-1 drugs were dispensed in the UK. Against that backdrop, regulators received 1,296 reports of pancreatitis of all flavors—acute, chronic, autoimmune, hemorrhagic, necrotising, and otherwise unpleasant.

Of those:

• 19 cases were fatal
• 24 were necrotising

That is not zero. It is also not an epidemic. It is pharmacovigilance doing exactly what pharmacovigilance is supposed to do: flag rare but serious adverse events in widely used drugs.

The MHRA’s conclusion was not “panic.” It was “tighten the warnings so clinicians don’t miss the signal.”

The Regulatory Subtext (Read This Slowly)

Pancreatitis has always been a known risk with GLP-1 drugs. This is not a discovery. What changed is volume. When millions more people take a medication—many privately, many off-label, many without robust continuity of care—you inevitably surface edge cases that were statistically invisible before.

The MHRA’s real concern is not that GLP-1s suddenly became dangerous. It’s that pancreatitis can be hard to distinguish early on from the garden-variety nausea, vomiting, and abdominal discomfort that GLP-1s commonly cause.

Translation: if someone shows up with persistent, radiating abdominal pain and is quietly injecting semaglutide obtained from a wellness clinic that doesn’t talk to their GP, clinicians need to know that fact before they send the patient home with antacids.

This is less about the drug and more about the ecosystem.

The Quiet Line That Matters Most

Buried in the advisory is the line lawyers will soon laminate:

“Privately prescribed GLP-1s and GLP-1/GIPs may not appear on the patient’s medical history.”

There it is. Phase Two meets Phase Three.

Unreported use. Fragmented care. Parallel prescribing systems. And now regulators politely reminding physicians to ask the obvious question: “Are you taking anything injectable that you didn’t bother to tell me about?”

Expect this sentence to appear verbatim in future complaints.

What the MHRA Did Not Say

They did not:

• withdraw the drugs,
• restrict prescribing,
• recommend discontinuation absent symptoms, or
• claim causality was newly established.

They strengthened labeling and told clinicians to stay alert. That’s it.

In regulatory terms, this is routine maintenance—not a five-alarm fire.

Why This Still Matters (Unfortunately)

This update lands at exactly the wrong cultural moment. We are already deep into Phase Three of the GLP-1 cycle, where litigation thrives on ambiguity and regulators’ cautionary language is recast as proof of malfeasance.

To the MHRA, this is a safety bulletin. To the plaintiff bar, it’s Exhibit A, freshly minted in bureaucratic prose.

And to the internet, it’s yet another reason to believe that modern medicine is lying to you, unless it comes in capsule form sold by a podcast host.

Bottom Line

The British government did what regulators are supposed to do: review data, acknowledge rare but severe outcomes, tighten warnings, and move on. No hysteria, no theatrics, no press conference with PowerPoint slides of flaming pancreases. Which, of course, means the rest of the world will now overreact accordingly.

And, of course, the lawyers are licking their chops.

Peptide Purgatory, published more or less weekly (whenever I feel like it), mixes one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity with a veritable plethora of opinions on the subject. Side effects may include sarcasm, elevated skepticism, and mild tachycardia. Ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: So Sue Me, Already! appeared first on The Nittany Turkey.

This edition of Peptide Purgatory features a personal health update after an action-packed senior week. I’ll cover the results of two scans I had earlier this week, give an update on my recovery from hernia repair surgery, and describe how I’m ramping my exercise program back up after eight weeks of enforced sloth. To set up a baseline for muscle mass and body composition, I’ve also scheduled a DEXA scan for early February. I’ll explain what that scan does, why it matters, and what I expect to learn from it. Finally, Bullshit Corner makes an appearance, inspired by the aggressively aspirational marketing machine attached to the very same company performing that scan.

A Paradox, or a Pair of Docs?

If you’ve followed my Mounjaro Updates—which somehow metastasized into Peptide Purgatory—you may recall a former physician whose pseudonym I no longer invoke, though his legacy of medical gaslighting and professional indifference lives on. This was the concierge doctor who once told me, without irony, “I can’t keep track of all your chronic conditions!”

Well. That was rather the point of the concierge fee, wasn’t it? So I canned his ass and moved on.

To be fair, he was right about one thing: I do, in fact, have a shitload of chronic conditions. Most are under control at the moment. At age seventy-nine, I’m in reasonably good health and far better shape than many men my age, but I’ve crossed into what Medicare politely calls the “elderly” category—bonus time, if you like. So yes, from time to time I bore you with updates on my expanding catalog of bodily quirks. It’s hereditary. My paternal grandmother was a career hypochondriac who suffered from every ailment known to medicine and then died inconveniently young at ninety-seven.

IPMNs: A “Vogue Diagnosis”

That same overwhelmed physician once ridiculed my gastroenterologist’s diagnosis of IPMNs in my pancreas as “the latest vogue diagnosis.” IPMN is an acronym I won’t expand here, but the short version is this: precancerous growths in the pancreatic ducts. You do not want things growing in your pancreas. If they turn malignant, you are, medically speaking, cooked.

These were first identified in 2023. A fine-needle aspiration at the time found them benign, but IPMNs are the sort of lesions that earn you a lifetime subscription to follow-up imaging, because some of them change character over time. Fortunately, my current physician—Dr. Macallan—takes the diagnosis seriously. He ordered an MRI to reassess the situation.

After spending most of Tuesday doing my best pins-and-needles impression, I finally received the imaging results. Here’s the spoiler: the IPMNs have not grown, there is no significant dilation of the main pancreatic duct, and there is no notable inflammation of the stomach or colon. Even better, there is no thickening of the stomach wall or fatty infiltration of the liver, suggesting that my chronic erosive gastritis has improved and my low-carb approach has worked well. Kidney cysts and my benign adrenal tumor were unchanged.

The hernia repair itself lies outside the MRI’s field of view, so the mesh couldn’t be directly assessed, but there were no signs of seromas or abnormal fluid accumulation.

In short, I can stand down from general quarters—for now—on the abdominal front.

Low-Dose Chest CT

Citing established guidelines, Dr. Macallan also ordered a low-dose chest CT because I once smoked. Never mind that I quit the same year Taylor Swift was born; the Former Smoker ID Card is apparently non-refundable. There was also an old pulmonary nodule on file that merited continued surveillance.

The results provided reason for continued watchful waiting. Despite excellent VO₂ max and spirometry results in late 2025, the scan showed early emphysematous changes (thank you, Marlboros) and a few new small nodules. The original nodule had grown only slightly. Given my history—three confirmed bouts of pneumonia, one requiring hospitalization back in 2002—these nodules are more likely infection remnants than anything more sinister.

Dr. Macallan wants a follow-up scan in one year. That seems reasonable. I’m not treating this as a ticking time bomb until it behaves like one.

Post-Hernia Surgery: The Ramp-Up

At our pre-surgery consult, Dr. O—my hernia surgeon—sentenced me to eight grim weeks of post-surgical muscle neglect, with a strict lifting limit of ten pounds. At the two-week follow-up, he showed mercy and raised the ceiling to twenty pounds, while hinting that I could return to real weight training sometime near the end of January. Until then, I was confined to my deeply resented five- and ten-pound neoprene dumbbells.

The end of January, mercifully, arrived.

And I’m back! Back to deadlifting—light, at around 135 pounds—and bench pressing again, equally conservative at about 100. I’ll ramp gradually toward my pre-surgery numbers, back when I thoughtfully gave myself the hernia in the first place. It felt spectacular to be back under a barbell after two months away. I plan to continue slowly, prudently, and with no wish whatsoever to test the tensile strength of surgical mesh. That means no belts, no Valsalva breathing, and no working to exhaustion.

My strategy is to increase loads during weeks eight through twelve, working five or six days per week as my body allows. I’ll alternate days between my home gym and the YMCA gym. At home I’ll do deadlifts, bench presses, dumbbell work, and kettlebell goblet squats. At the Y, I’ll do cardio and weight machines like lat pull-downs, rows, and overhead presses. I’ll keep it simple, eschewing accessory exercises. And I’ll avoid stressing the core, giving the hernia repair an extra four weeks to heal.

To set a baseline for this rebuild, I’ve scheduled a DEXA scan for February 11 with a company called DexaFit. They would very much like to sell me far more than a DEXA scan, which I’ll tackle in Bullshit Corner. For those who only associate DEXA with bone density testing, the scan also provides detailed data on lean mass, muscle mass, fat distribution, and regional composition. What I want is a granular, location-specific snapshot—something precise enough to measure whether my training is preserving muscle rather than merely flattering my optimism.

That, at least, is the plan. Read on to learn how DexaFit has a grander plan for me—and my wallet.

See You Next Week

Thanks for bearing with me in this “all about me” issue. I hope some of you find some of my medical travails interesting, for whatever reason. Schadenfreude is permissible and, in fact, encouraged here. Nevertheless, I promise to get back to non-egocentric issues next week.

I’ll let you know what I’m working on. In past issues, we’ve looked at how Big Pharma has created a market for GLP-1 receptor agonists and ramped it up exponentially. We’ve dissected the secondary market, disdaining the opportunistic compounding pharmacy/telehealth players. Last week, we explored the food and food supplement industry hopping on the GLP-1 bandwagon. So, it is completely expected that the plaintiff bar would sit up and take notice of the potential for large jury awards relating to GLP-1s. We’ll deal with that sordid mess next week, right here in Peptide Purgatory.

In the meantime, stay warm and good health to all!

Peptide Purgatory, published more or less weekly, mixes one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity with a veritable plethora of opinions on the subject. Side effects may include sarcasm, elevated skepticism, and mild tachycardia. Ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: Scan Me Up, Scan Me Down appeared first on The Nittany Turkey.

The Arguments and the Reality

Every few years, amateur radio rediscovers one of its favorite parlor games: arguing about whether that change finally killed the hobby. Incentive licensing. No-code licenses. Digital modes. Remote operation. Pick your poison. Pour coffee. Assume the position.

This time, though, my attention has drifted away from the great code kerfuffle and toward a question more interestingly intrinsic—and frankly, more uncomfortable: What the hell do our licenses actually mean anymore?

I’ll stipulate a few things up front to avoid the blood pressure spike. Code still matters technically. CW remains unmatched for weak-signal work, and anyone who says otherwise is arguing with physics and human neurophysiology, not me. At the same time, the FCC’s elimination of the code requirement back in 2007 did not trigger an extinction event. Eighteen-plus years later, the bands are still there, the repeaters still work, and the sky has not fallen—although some folks have been yelling “incoming” ever since.

But focusing on code misses the larger point. The deeper issue is not what was removed from the licensing process, but what replaced it. And the short answers is: not much.

Testing Competence vs. Memory

When I earned my General in 1960, the written exam was not something you “studied for” in the modern sense. You prepared because you had to understand. Drawing schematics was not a novelty; it was the expectation. The Extra Class exam—back when it required 20 WPM CW—was a capstone, not a participation trophy. You didn’t stumble into it. You climbed.

Fast forward to today. The current Amateur Extra exam is a 50-question multiple-choice exercise drawn from a published question pool. As a Volunteer Examiner, I’ve had examinees cheerfully explain their strategy: “If you can’t handle the math, just skip that part and memorize the rest.” And they’re right. The system permits it. The exam rewards recognition, not reasoning.

The predictable outcome? Extras who hold the credential but not the conceptual framework that credential once implied. Two weeks after retrieving their license, they would be hard pressed to even repeat the answers they got right, let alone the concepts underlying them.

Extra Class Pedestrians

Friends and fellow hams, I am not making this up. I know one Extra who asked whether the number printed on the top of an ATC fuse referred to volts or amps. Another chronic loudmouth pontificated that to compare signal strengths expressed in decibels, we should divide rather than subtract. These are not trick questions. These are fundamental misunderstandings. Yet both individuals hold the highest amateur license the FCC issues.

If this were an isolated anecdote, I’d shrug and move on. It isn’t. What we are seeing is credential entropy: the gradual decoupling of a license from the knowledge, skills, and judgment it was once assumed to represent. The piece of paper stays the same. The informational density behind it thins.

Go to social media ham radio groups (if you are a masochist) and you’ll find them replete with inane questions from hams with two-letter call signs. The responses from their peers are even sillier, ranging from misleading old wives’ tales to frankly incorrect solutions, peppered with a few quiet (because they’re bound to be shouted down by pseudo-experts) correct answers. And then, there’s the classic response: RTFM (read the f*cking manual), typically uttered by those who never read it themselves.

“I’ve Got a First-Class Commercial Radiotelegraph Certificate!”

Interestingly, some hams react to this decline in signaling value by chasing harder credentials. I know several who pursued FCC commercial Radiotelegraph or Radiotelephone licenses long after any employer cared. Some did it for work, and they are very quiet about it. Others did it for differentiation—to prove, mostly to themselves, that they still clear a high bar in a hobby where the bars have been steadily lowered.

That split is telling. When a system no longer creates meaningful gradients internally, people import them from elsewhere. Contest scores. DXCC tallies. Club operating awards. Commercial tickets. Anything that says, “I didn’t just show up; I learned something.”

Are We Doomed to Extinction?

None of this means amateur radio is doomed. But it does mean it is no longer self-ordering. Rigor has become optional. Mastery is elective. And credentials—once a rough proxy for competence—now function more like merit badges. Nice to have. Reassuring. Occasionally decorative.

Before anyone fires up the email cannon, let me be clear: I am not advocating reinstating code exams, nor am I proposing a licensing Hunger Games where only the strong survive. Accessibility has value and growth matters, but so does meaning. When the highest credential in a technical service no longer reliably signals technical literacy, something important has been lost—even if it was lost politely.

So yes, this sounds like negativism. Or doomsaying, if you will. Or the grumbling of an old fart with too many memories and not enough patience. Fair enough. But if amateur radio wants to remain more than appliance operation with nostalgia sprinkled on top, it needs to ask an uncomfortable question: Are our licenses certifying achievement—or merely recording attendance?

I’ll leave that there. If nothing else, it should make for livelier debate than the usual “ham radio died when they eliminated code” reruns. And if it doesn’t, well… entropy always wins eventually.

The post Entropy, Merit Badges, and the Amateur Extra Who Couldn’t Find the Fuse appeared first on The Nittany Turkey.

Our lead story is just the latest example of “GLP-1sploitation”, which seems to be following Pat Buchanan’s famous progression: from an idea… to a cause… to a movement… to a racket. Big Pharma generated the idea, its marketing arm amplified the cause to a movement, and now the GLP-1 ancillary market has become a racket. This week: Big Fooda Goes All-Ahead Flank!

GLP-1 Friendly PART ONE: Now With More Marketing Than Meaning

It was inevitable.

Once GLP-1 RA drugs such as Mounjaro, Ozempic, Wegovy, and Zepbound escaped the clinic and entered the cultural bloodstream, the food industry was never going to sit this one out. When tens of millions of Americans are injecting a medication that suppresses appetite, slows gastric emptying, and rewires satiety signals, there is only one rational response from Big Fooda: slap a reassuring label on a box and hope nobody asks too many questions.

Thus we arrive at the era of “GLP-1 Friendly” foods.

This phrase sounds medical. It feels clinical. It whispers, don’t worry, this product understands you now. Unfortunately, it means approximately nothing.

Invented Terminology

There is no FDA definition of “GLP-1 friendly” and no defined clinical standard. There is not even a loose consensus. The term exists in the same regulatory limbo as “keto friendly”, “heart healthy,” “clean,” and “artisan,” all of which have been abused so thoroughly that they now function primarily as red flags.

And yet here they are, stacked neatly in grocery freezers and smoothie shops, smiling benignly at people who are already navigating a complex pharmacologic reality.

Let’s get something out of the way early: people using GLP-1 receptor agonists do not have special nutritional requirements. They are not members of a new dietary religion. They do not require blessed foods prepared by certified GLP-1 monks.

What is different is volume. Appetite suppression means fewer calories. Fewer calories mean each bite matters more. That’s it. That’s the whole secret. Protein and fiber matter more because math matters more.

Nothing Novel Here

Protein did not become important when semaglutide hit the market. Fiber was not discovered by Novo Nordisk. Hydration did not suddenly emerge as a concept because someone injected tirzepatide. These are baseline human requirements that have been quietly ignored for decades, now being reintroduced with a trademark symbol.

And this, my friends, is how we end up with absurdities like “GLP-1 friendly” frozen pizzas that manage to deliver heroic amounts of sodium and saturated fat while waving a protein banner like the gigantic American flag at the Super Bowl. Apparently, nausea, indigestion, and acid reflux are “friendly” now. Who knew? Oy, vey, already!

Or how about smoothies proudly branded for GLP-1 users that contain more calories, sugar, and cholesterol than a Krispy Kreme donut? Somewhere, a continuous glucose monitor just emitted a terminal beep as it melted down into a searing blob of steaming electronic waste.

GLP-1sploitation?

This is not nutrition. It is profit-driven opportunism, banking on the vulnerability and gullibility of the GLP-1 patient population.

GLP-1 drugs are neither food preferences nor intolerances nor macros. They are medications that alter neurohormonal signaling and gastrointestinal physiology. You cannot make a food “compatible” with that any more than you can sell “beta-blocker friendly” espresso or “statin approved” cheesesteaks.

But nuance is not the point. Normalization is.

Phase Two Entropy

We are now in phase two of the GLP-1 aftermarket. Phase one was the Wild West: influencers, compounding pharmacies, shortage hysteria, and people injecting mystery peptides sourced from the metabolic equivalent of a vape shop. Phase two is corporate calm. Clean packaging. Official-looking labels. Just enough dietitian quotes to keep the lawyers comfortable.

Phase three, if history is any guide, will be quiet retreat and rebranding once consumers realize the label does not, in fact, protect them from bad food choices.

There is also a more insidious problem lurking here: the resurrection of diet culture, freshly embalmed.

GLP-1 drugs threatened to end the morality play around eating. Appetite regulation without shame was the whole point. But the moment food companies start whispering you still need the right foods to succeed, the old guilt engine sputters back to life. Same script, new fonts.

Only the Beginning…

And mark my words, Turkey readers: we are only at the beginning. Today it’s frozen meals and smoothies. Tomorrow it will be gluten-free, non-fat, GLP-1 friendly popsicles with only 20 grams of added sugar and 5 grams of fiber—available, of course, only if you eat the stick. Serving size: one-third of a popsicle, because personal responsibility builds character.

The truly ironic part? If food companies dropped the drug references entirely and simply said what they mean—higher protein, decent fiber, smaller portions, tolerable fat content—they would be doing something genuinely useful. But “nutrient dense and modestly portioned” doesn’t move units like a vogue pharmaceutical costume party.

So here is the rule of thumb, free of charge: if a food product needs to name-drop your prescription medication to justify itself, it is already losing the argument.

The drug works because it changes physiology. The label works because it changes perception. Confusing the two is not just marketing bullshit—it’s how we end up right back where we started, only with better packaging and worse honesty.

And yes, the popsicles are coming.

Part Two: A Case Study in GLP-1sploitation — Replenza

Every trend eventually produces its flagship nonsense. In the GLP-1 economy, that flagship appears to be Replenza.

Several months ago upon seeing a prominent, splashy display, I purchased a jar of the magical elixir from my neighborhood Publix supermarket, thus feeding the Replenza Labs’ bottom line, no doubt benefitting the Wayne, NJ economy.

Replenza bills itself as “physician-formulated GLP-1 support,” a phrase carefully concocted to sound medical while remaining almost aggressively nonspecific. Support how? What? Who? The website never quite says—because saying would require mechanisms, evidence, or at least a testable hypothesis.

Instead, we are offered bullshit.

Special Nutritional Needs

According to Replenza’s marketing, people on GLP-1 medications have special nutritional needs that conveniently align with a proprietary two-product “system.” Appetite suppression, we are told, creates gaps that only Replenza can fill—through a curated blend of protein-adjacent compounds, fiber dustings, electrolytes, adaptogens, enzymes, probiotics, collagen, and an assortment of vitamins that have never met a calorie deficit they couldn’t theoretically help. And what in the bloody hell are adaptogens?

Medical science? Nein, nein — this is nutritional astrology.

Let’s be clear: people eating fewer calories may indeed benefit from adequate protein, fiber, and micronutrients. That is neither controversial nor novel. But it is also not unique to GLP-1 users. Anyone dieting, fasting, ill, stressed, or simply disorganized with food intake falls into the same category. None of this requires a drug-branded supplement ecosystem.

But Replenza does not sell adequacy. It sells relevance.

Science-Backed!

The website leans heavily on authority signaling: “physician-formulated,” “science-backed,” “expert-designed.” There is a board, advisors, and testimonials. What there is not, anywhere, is evidence that this product interacts meaningfully with GLP-1 pharmacology, alters outcomes, preserves lean mass, improves tolerability, or does anything beyond what a competent diet and a basic multivitamin might already accomplish.

What is present is a masterclass in additive buzzword stacking. If you can’t dazzle them with your brilliance, baffle them with your bullshit!

Muscle recovery is promised via BCAAs (branched chain amino acids)—without sufficient total protein to make them useful. Collagen is invoked for skin elasticity, despite being nutritionally incomplete and largely irrelevant to muscle preservation. Digestive health is waved at using two grams of prebiotic fiber, which is less “support” and more “token fiber.” Electrolytes appear largely for aesthetic purposes. Green tea extract—standardized to caffeine—sneaks in for “energy,” because nothing says GLP-1 tolerance like adding stimulants to an already nausea-prone population.

And then there is the formulation itself.

It Floats!

My observation: despite vigorous stirring, shaking, swirling, and genuine effort, the powder does not dissolve. It floats. I can stir it or shake it vigorously, but it still floats. It sits smugly on the surface of the water, unmixed, unbothered, and curiously on-brand. Reminds me of barium sulfate, except barium sulfate has the decency to be honest about wearing the crown of insolubility.

This is not a trivial observation. GLP-1 users already contend with delayed gastric emptying. A product that resists dispersion before ingestion is almost satirical. It is as though the supplement itself is refusing to engage—mirroring its relationship to the drug it claims to support.

The symbolism is exquisite.

A supplement that borrows the legitimacy of a prescription therapy while remaining nutritionally generic, mechanistically detached, and physically insoluble is not malfunctioning. It is expressing its truth. It floats above the liquid the same way its claims float above physiology.

No Harm Done, Other than the Wallet

Replenza does not harm GLP-1 users. That would require meaningful interaction. What it does instead is monetize proximity—standing close enough to a real therapy that consumers may assume relevance where none has been demonstrated.

This is GLP-1sploitation at its most refined.

No outrageous claims.
No explicit lies.
Just careful implication, authoritative tone, and a supplement formula that would look perfectly at home in any wellness aisle if you scraped the acronym off the label.

If Part One of this article examined how food companies learned to whisper “GLP-1” without saying anything, Part Two shows how the supplement industry learned to shout it—while still meaning nothing.

And yes, the popsicles are still coming.

Peptide Purgatory, published more or less weekly, mixes one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity with a veritable plethora of opinions on the subject. Side effects may include sarcasm, elevated skepticism, and mild tachycardia. Ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post PEPTIDE PURGATORY: The GLP-1 DIETARY REVOLUTION! appeared first on The Nittany Turkey.

A Case Study in Organizational Entropy

Every volunteer organization believes its problems are unique. The personalities are different, the bylaws are idiosyncratic, the history is special. Yet when you step back far enough, familiar patterns emerge—patterns that have little to do with individuals and everything to do with system design.

What follows is an examination of one such organization, the 3905 Century Club, a ham radio award net organization, not as an exposé, but as a representative scenario. Substitute the name, the hobby, or the mission, and much of this analysis will still apply. The details are parochial; the dynamics are not.

The Election Signal That Should Not Be Ignored

In healthy organizations, elections are noisy. Multiple candidates emerge organically. Outcomes are uncertain. Participation is visible, and losing candidates still confer legitimacy by their presence alone.

In the 3905 Century Club, that condition ceased to exist after 2018.

The danger is not collapse; it is permanence without relevance.

The 2018 presidential election was the last contest that could reasonably be described as competitive. Multiple credible candidates ran. Voters had real choices. Participation spiked accordingly.

From 2020 forward, the pattern changed decisively. Each presidential election featured the incumbent opposed by a nominal challenger—hand-selected, publicly deferential, and structurally incapable of winning. Although those placeholder candidates received non-trivial numbers of protest votes, the outcome was never in doubt. The election served not to select leadership, but to ratify it. Dissenting votes were quietly acknowledged in results listings, then relegated to obscurity.

This is not merely an aesthetic problem. In systems terms, this marks the transition from a selection mechanism to a confirmation ritual. Once participants understand that outcomes are predetermined, rational actors disengage. Voting becomes optional. Attention evaporates.

The declining vote totals that follow are not apathy; they are feedback that leadership should not ignore.

Participation as a Leading Indicator

Organizations often fixate on membership counts because they are easy to track. Participation is harder—and far more important.

In the subject organization, Presidential vote totals peaked long ago, with the high-water mark around 2010. Even allowing for fluctuations, the long-term trend is unmistakable: declining engagement well before membership growth flattened.

That ordering matters. Participation collapses before membership stagnates, not after. The system first loses its active core, then coasts on inertia, maintaining the appearance of functionality. Elections continue, boards meet, and awards are issued. From the outside, everything looks great. Internally, entropy is already accumulating.

Flat Growth Is Not Stability

Recent membership data appears superficially reassuring. New member counts since 2010 hover within a relatively narrow band year over year. There is no cliff, no dramatic collapse. But flat growth in a volunteer organization with lifetime membership is not neutral. It masks silent attrition.

Because membership does not require renewal, departures are invisible. Disengagement leaves no trace. Members simply stop participating, stop voting, stop showing up. The ledger does not change, but the organism does.

In systems language, this is retained mass with declining energy—a structure that looks intact while its internal dynamics decay.

Governance Drift and Rule Proliferation

As participation declines, governance pressure increases. Fewer active volunteers must manage the same institutional load. Rules proliferate to compensate for missing trust. Edge cases drive policy. Exceptional behavior becomes normalized through procedural accommodation.

The result is a paradox: more process, less accountability.

Directorial attendance rules are debated but not enforced. Member removal thresholds are softened. Special circumstances become routine. Elections are extended, deferred, or reclassified. Each change is defensible in isolation. Collectively, they signal a system optimizing for continuity of office, not quality of representation.

This is not malice. It is adaptive behavior in a closed system attempting to preserve equilibrium.

The Closed-System Trap

At some point, the organization becomes internally referential. Leadership selection draws only from those already inside the governance loop. New entrants see no plausible path to influence. Elections cease to be aspirational.

The system still functions—but only for itself.

This is the hallmark of a closed system: high internal coordination, low external permeability, and steadily declining informational diversity. The organization does not fail dramatically. It simply becomes irrelevant to anyone not already embedded within it.

Why This Matters Beyond One Club

None of this is unique to amateur radio, awards programs, or volunteer boards. The same dynamics appear in professional associations, nonprofit boards, open-source projects, and civic organizations.

When:

• elections cease to be competitive,
• participation declines faster than membership,
• governance expands while engagement contracts, and
• outcomes become predictable,

instead of “aging gracefully,” the system is consuming its own optionality.

The Systems Lesson

Healthy organizations are noisy. They tolerate inefficiency, allow contested outcomes, accept that not every election produces unity, and not every volunteer stays forever.

Closed systems fear that noise. They replace it with ritual.

The danger is not collapse; it is permanence without relevance.

The lesson, uncomfortable as it may be, is that stability is not the same as health—and longevity is not proof of vitality. Systems that stop renewing their internal energy do not need enemies. They quietly optimize themselves into stasis.

Recognizing that pattern is the first step toward reversing it—if reversal is still possible.

The post When Participation Becomes Performative appeared first on The Nittany Turkey.

This is a different approach for me. Typically, I read one or two current medical news digests on a subject and grind it into a short article. The NotebookLM approach gathers information from many diverse sources and takes the writing out of my hands. Thus, it will be drier than usual, but more informative.

The subject is one that I have harped on since I began chronicling my progress on Mounjaro: the loss of muscle mass associated with rapid weight loss facilitated by GLP-1 RA drugs. Read on. I learned quite a lot from what NotebookLM put together for me.

Mounjaro, Muscle, and Your Metabolism: 5 Things No One Is Telling You

The Hidden Price of Revolutionary Weight Loss

Glucagon-like peptide-1 (GLP-1) medications like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) are nothing short of a public health revolution. Their popularity has skyrocketed—use has increased by a staggering 587% in the last five years—and for good reason. Clinical trials show these drugs can produce a mean weight loss of 15% to 21%, results previously achievable only through surgery.

But this incredible success comes with a serious clinical concern, a hidden cost that is only now entering the conversation. While the number on the scale goes down, another critical health metric may be declining right along with it, potentially undermining the long-term benefits of the weight loss itself. The question is no longer “Do these drugs work?” but “What are they doing to your body in the long run?” The answers are more surprising—and urgent—than you think.

1. The “Sarcopenia Emergency”: You’re Losing More Muscle Than You Think

This is the most critical takeaway: a significant portion of the weight lost on GLP-1 therapies is not fat. According to clinical data, anywhere from 15% to 40% of the total weight lost can come from lean muscle mass. This has prompted some experts to sound the alarm about a “Sarcopenia Emergency.”

Losing substantial muscle mass during weight loss treatment isn’t a trivial side effect; it’s a direct threat to long-term health. This level of muscle loss increases the risks of frailty, reduces metabolic rate, and creates a state of metabolic instability that can make it harder to sustain weight loss over time. One clinical analysis put it starkly:

…essentially creating a longevity disaster that undermines the very health benefits they sought.

This is a dangerous paradox. Patients take these medications to improve their health, but unintentionally losing this much muscle could compromise their strength, mobility, and metabolic resilience for years to come.

2. Not All “Lean Mass” is Muscle (And Some Loss is Unavoidable)

The alarming headlines about “lean mass” loss are missing a crucial piece of the puzzle. Here’s why a significant portion of that loss is not only expected—it’s unavoidable and doesn’t come from your functional muscles.

The confusion stems from conflating “Fat-Free Mass” (FFM) with “skeletal muscle.” According to fundamental body composition principles, FFM is a molecular-level metric that includes everything that isn’t fat: water, protein, organs, and bone. Your bicep is just one component of your total FFM.

This distinction matters because of a concept called “obligatory loss.” Think of adipose tissue (body fat) not as a pure block of lard, but as a water-logged sponge. The sponge material is its “fat-free” component—water, protein, and connective tissue. Scientific models show adipose tissue is roughly 80%-85% fat, with the rest made up of water (?15%) and protein (?5%). When you lose a lot of fat, you’re not just draining the lard; you’re also losing the weight of the water-logged sponge material that held it. This “obligatory loss” is substantial and has nothing to do with your biceps.

This doesn’t dismiss the very real concern of losing functional skeletal muscle, but it provides critical context. Not every pound of “lean mass” lost on a body composition report is a pound of lost quadricep muscle.

3. The Surprising Paradox: GLP-1s May Improve Muscle Quality

Herein lies a fascinating paradox. While GLP-1 medications are associated with a loss of muscle mass, emerging research suggests they may have a positive effect on muscle quality at the cellular level. While the scale shows your muscles shrinking, at a microscopic level, these drugs may be quietly upgrading the quality and efficiency of the muscle that remains—a fascinating biological contradiction researchers are racing to understand.

A recent systematic review of preclinical studies found that GLP-1 receptor agonists appear to have a positive effect on skeletal muscle mitochondria—the “powerhouses” of your cells. The review of animal and in vitro models showed that the drugs seemed to increase mitochondrial area and number while also improving their morphology (i.e., reducing swelling and damage).

Researchers caution that these are early, preclinical findings, and human studies are needed to confirm if this effect translates to people. Nonetheless, it points to the complex, dual effects these medications might have on muscle tissue, potentially contributing to a loss of overall mass while simultaneously improving the health of the remaining muscle cells.

4. The Rebound Is Real: Stopping Abruptly Can Be a Metabolic Disaster

For those who view these medications as a short-term solution, clinical data offers a sobering reality. Studies show that patients typically regain two-thirds of their lost weight within just one year after stopping GLP-1 therapy.

Stopping the medication doesn’t just return you to your baseline; it can leave you in a worse position. After losing metabolically active muscle (as discussed in our first point), regaining primarily fat tissue can permanently lower your resting metabolism, making future weight management even harder. It’s a metabolic trap. The reason for this dramatic rebound is physiological. Abruptly discontinuing the medication can trigger metabolic instability as hunger-regulating hormones, such as ghrelin, surge, leading to intense hunger and preoccupation with food.

However, there is a clear solution. Research suggests that a gradual tapering strategy over nine or more weeks can help patients maintain their weight loss or even continue losing weight. This underscores the importance of viewing these drugs not as a quick fix but as a long-term therapy that requires a strategic and supervised “exit plan” to lock in the benefits.

5. Your Defense Plan Is More Than Just “Exercise and Protein”

Generic advice to “eat more protein and exercise” isn’t enough to combat the significant muscle loss associated with GLP-1s. A successful muscle preservation strategy must be specific, targeted, and backed by data. Here are three non-negotiable components.

Resistance Training is Non-Negotiable

Resistance training (i.e., weight training) is considered the single most effective way to stimulate muscle growth and combat muscle loss. Studies have shown that combining a structured resistance training program with GLP-1 therapy can help preserve fat-free mass while actually potentiating fat loss.

Get Precise With Your Protein

Adequate protein intake is paramount for giving your body the building blocks it needs to preserve muscle. While many people on these drugs struggle with appetite, hitting a specific protein target is crucial. The evidence-based goal mentioned across multiple sources is a protein intake above 1.2 g/kg/day. For a 180-pound person, that’s over 98 grams of protein daily—significantly higher than the standard Recommended Dietary Allowance (RDA) for most adults. That’s the equivalent of nearly four chicken breasts or over a dozen large eggs per day, underscoring the need for a focused nutritional strategy.

Consider a Supplemental Edge

Two key supplements have strong evidence supporting their role in muscle preservation, particularly during periods of weight loss.

• Creatine: A typical dose of 3-5 grams daily has been shown to help preserve muscle mass and boost exercise performance, allowing for more effective workouts that stimulate muscle retention.
• HMB (beta-hydroxy beta-methylbutyrate): HMB is a metabolite of the essential amino acid leucine. Its primary function is to reduce muscle protein breakdown. A recommended dose is around 3 grams daily.

From Weight Loss Provider to Strategic Health Architect

These drugs are not a simple tool for weight loss; they are profound metabolic modifiers. They trigger a “Sarcopenia Emergency” (1) that isn’t fully explained by standard “lean mass” readings (2), yet they may paradoxically improve muscle at a cellular level (3). This complexity demands a strategic exit plan to avoid a metabolic rebound (4) and a highly specific defense protocol to protect your long-term strength (5).

The goal should not be simple weight loss, but strategic body composition management—maximizing fat loss while fiercely protecting metabolically crucial muscle tissue. As these revolutionary drugs become more common, will we learn to use them not just to get lighter, but to become metabolically stronger for the long run?

Summary: What This Actually Means in the Real World

Strip away the marketing gloss and the tribal cheerleading, and the takeaway is blunt: GLP-1 receptor agonists are extraordinarily effective tools for weight loss, but they are metabolically indiscriminate. They shrink fat, yes—but they also shrink muscle, and not in trivial amounts. The much-quoted “lean mass loss” numbers are often misunderstood, but even after accounting for water and structural tissue, real skeletal muscle loss remains a legitimate concern, particularly for older adults and anyone who values strength, mobility, or metabolic durability.

At the same time, the picture is not cartoonishly bleak. Some muscle loss is unavoidable during rapid fat loss, regardless of method. Emerging data even suggest that GLP-1s may improve muscle quality at the cellular level, a paradox that will no doubt fuel grant proposals for the next decade. But improved mitochondrial morphology is cold comfort if you’ve surrendered enough contractile tissue to make stairs negotiable and grocery bags aspirational.

Perhaps most importantly, this article demolishes the fantasy that these drugs are a short-term intervention. Abrupt cessation predictably leads to weight regain, often with a worse body composition than before. That is not failure of willpower; it is physiology doing exactly what it has evolved to do. Without a tapering strategy and a plan to preserve muscle, stopping GLP-1s is less an exit ramp than a metabolic trapdoor.

Finally, the prescription for mitigating these effects is neither mysterious nor optional. Resistance training is not a lifestyle flourish—it is structural reinforcement. Protein intake must be deliberate and sufficient, not hand-waved with vague dietary platitudes. Supplements like creatine and HMB are not magic, but they are among the few tools with credible evidence behind them. In short, passive weight loss requires active countermeasures if the goal is health rather than just a smaller belt size.

Conclusion: Weight Loss Is Easy; Strength Is Earned

The real danger with GLP-1 drugs is not that they don’t work—it’s that they work so well they seduce users into thinking nothing else matters. The scale drops, the applause follows, and muscle quietly exits stage left. By the time anyone notices, the damage is already amortized across years of reduced metabolic rate, diminished resilience, and increased frailty.

If these drugs are to be used responsibly—and they are here to stay—they must be reframed not as weight-loss agents but as metabolic interventions that demand competent management. That means planning for muscle preservation from day one, not as a regret-driven add-on six months later. It means acknowledging that appetite suppression is not a substitute for mechanical loading of muscle, and that protein targets are not aspirational slogans but engineering requirements.

Weight loss is easy now. That is the miracle. Staying strong while doing it is the hard part—and that remains stubbornly analog, involving iron, effort, and intent. GLP-1s can make you lighter. They will not make you sturdier. That part is still up to you.

Peptide Purgatory, published almost weekly (but somewhat weakly), chronicles one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia while reading policy papers. So, ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: GLP-1 Muscle Loss In Depth appeared first on The Nittany Turkey.

It is tempting to dismiss this as boredom. “Same old weather reports,” “same call signs,” “same jokes.” But that diagnosis is shallow. What is happening on many nets is not a failure of imagination; it is a structural failure of engagement. The problem is not what is being said, but how the system is designed to operate.

1. Predictability Is Not Comfort—It’s Exhaustion

Predictability feels safe to insiders. It feels dead to everyone else.

Many nets have optimized themselves into near-perfect routines. The order is fixed, the participants are known in advance, and the content is so repetitive that it becomes informationally empty. You can often predict, with eerie accuracy, who will check in and how they will proceed even before the net begins.

That level of predictability is a classic sign of entropy in a social system. No further variation is achievable, so nothing new can emerge. Efficiency has replaced curiosity.

For someone new, that is fatal. Waiting an hour for a ritualized thirty-second call is not a rite of passage; it is a deterrent. Nets like this are no longer conversations but are scripts read aloud.

2. “Welcoming” Can Still Mean Closed

Most net control operators are polite. Many are genuinely friendly. Yet newcomers frequently report feeling invisible after their first check-in. A “thanks for checking in” is followed immediately by a return to insider conventions, shared history, and assumed context.

This is not intentional exclusion. It is something subtler and more corrosive: internalization. Over time, groups evolve shorthand, habits, and conversational loops that make perfect sense to those already inside—and no sense at all to anyone else. The net stops being a place where relationships form and becomes a coordination exercise among people who already know one another.

New stations get a few calls and quickly fade into the non-insider noise. They are useful only as new contacts. Once used, their value diminishes. Only a few will ever surmount this tacit ostracism.

3. Making Things Easier Often Makes Them Meaningless

When participation drops, organizations frequently respond by loosening requirements. Awards become easier. Contacts become more plentiful. They create special events and novel paradigms to increase participation.

On paper, productivity improves. In reality, meaning drains away.

When recognition no longer reflects persistence, skill, or real operating challenges, it becomes ceremonial. Awards stop signaling accomplishment and start signaling attendance. The system appears active while quietly undermining its own incentives.

This is entropy masking: visible output without corresponding engagement. It keeps dashboards green while hollowing out the experience for everyone involved.

4. The Barriers Aren’t Tests or Equipment—They’re Culture and Privacy

For decades, discussions about declining participation focused on licensing exams and equipment cost. Those matter, but they are no longer the dominant barriers.

Cultural friction matters more. On-air behavior that drifts into political ranting, hostility, or performative grumpiness drives people away quickly—and permanently.

Privacy matters even more. The requirement that a license holder’s home address be publicly searchable is an enormous deterrent for many potential operators, particularly women and younger hams. To someone raised in an era of data breaches and stalking awareness, this feels less like transparency and more like institutionalized doxxing.

A hobby that requires sacrificing personal privacy as the price of admission should not be surprised when people choose not to participate.

5. Where the Energy Actually Went

The most important point is this: interest in ham radio has not vanished. It has migrated.

Look at Parks on the Air (POTA). There is no net control. No schedule. No roll call. Operators activate parks when they want; others hunt them when propagation allows. Contacts are meaningful precisely because they are not guaranteed. Every QSO is an emergent event shaped by geography, timing, and RF conditions.

Or consider the Straight Key Century Club, founded in 2006 and now exceeding 30,000 members—averaging roughly 1,500 new members per year. CW-only. No modernization gimmicks. Heavy emphasis on skill and participation. It thrives because it is coherent, socially visible on the air, and culturally intentional. Constraint, not convenience, gives it meaning.

Other long-time bastions of ham radio activity, such as Field Day, contesting, and DX chasing still thrive.

These are not accidents. They are open systems, which allow autonomy and reward participation directly rather than ceremonially. They make engagement visible and absence noticeable.

Re-Tuning the Question

The mistake is asking, “How do we save traditional nets?”

That assumes the structure is sound and only needs cosmetic fixes.

The better question is: what forms of on-air community actually work now? What designs encourage curiosity, autonomy, skill, and real interaction rather than ritualized compliance?

Some nets may adapt. Many will not. That is not tragedy; it is selection pressure.

Ham radio has always been at its best when it rewarded experimentation rather than obedience. The bright spots—POTA, SKCC, and similar efforts—are not departures from tradition. They are reminders of what made the hobby compelling in the first place.

The static did not come from the bands.
It came from the structures we stopped questioning.

The post Beyond the Static: Why So Many Ham Radio Nets Are Fading appeared first on The Nittany Turkey.

In this week’s issue, we present yet another example of ostensibly scientific literature aimed at expanding the GLP-1 receptor agonist market. Yeah, I know — ho hum — a recurrent theme here. I’m not beating a dead horse; I’m grinding it up and making horse meat. But mark my words: by the end of the decade, you’ll be able to buy these drugs at the local 7-11.

In addition to taking the proverbial piss on Big Pharma, a regular occurrence around here, I’ll be supplying an update regarding my personal health progress and my most recent visit with young Dr. Macallan, my fresh-faced direct primary care physician who replaced the legendary overpriced pseudo-concierge doc, Dr. DeLorean. (For those new to The Nittany Turkey, those are not their real names).

GLP-1 Market Now 800,000,000 People

The latest offering from The Lancet Diabetes & Endocrinology performs a neat little trick: it dresses up market sizing as global health policy and calls it epidemiology. By the authors’ own math, more than one in four adults worldwide—roughly 800 million people—now “qualify” for GLP-1 receptor agonists. Instead of a treatment guideline, consider this a PowerPoint slide for an earnings call for Novo Nordisk or Eli Lilly.

The eligibility criteria are familiar, almost comforting in their simplicity: BMI >= 30, or BMI >= 27 with hypertension or diabetes. Expand that slightly for Asia, stir in pooled surveys from 99 countries, and voilà—an addressable market so vast it would make a tobacco executive blush. One almost expects a footnote reading “numbers may vary depending on quarterly guidance.”

Injectable Drugs First, Common Sense Later

What is striking is not that obesity is prevalent. We already knew that. What is striking is how seamlessly the scientific community now accepts the premise that pharmacologic intervention at population scale is the default response, while upstream causes—food policy, agricultural subsidies, urban design, and the relentless industrialization of calories—are relegated to the final paragraph as a sort of moral appendix. Yes, the paper dutifully nods to “multilevel agricultural and food policies,” but only after the damage has been fully monetized.

The scale of potential eligibility for GLP-1 receptor agonists, combined with their high costs, demands strategic, tailored policies and programmes to integrate GLP-1 receptor agonists in routine care.

Government agencies, for their part, are portrayed not as regulators but as enthusiastic integrators—creating guidelines and exploring policies to fold lifelong injectable therapy into routine care. Translation: public payers are being prepped to underwrite what marketing departments have already normalized. When WHO is name-checked in the opening section, you can practically hear the cash registers warming up. Ka-ching!

Obesity: A Chronic, Relapsing Disease

And let us not pretend this is happening in a vacuum. Eli Lilly and Novo Nordisk did not merely stumble into this moment through plucky Scandinavian innovation. They cultivated it—through trials, advocacy, disease re-definition, and a careful reframing of obesity from a societal failure to an individual pharmacologic deficiency. The scientific literature, increasingly populated by eligibility studies like this one, provides the intellectual scaffolding. The state provides the reimbursement. The companies provide the pens.

None of this means GLP-1 drugs are ineffective. They are, by most measures, remarkably effective. But when a quarter of the adult human population is suddenly “eligible” for a branded injectable therapy, the correct response is not applause. It is skepticism. Medicine is supposed to treat disease, not declare most of humanity suboptimally medicated.

If this is the future of public health—identify a widespread condition, redefine the threshold, publish a global count, and hand the invoice to governments—then we should at least stop pretending this is accidental. It is a business model. And judging by the numbers, it is a very good one.

My Week on Mounjaro: Annual Physical (Sort Of)

Dr. Macallan runs a direct primary care practice. For those unfamiliar with the direct primary care model, this is a recent workaround for the health insurance morass. Direct primary care docs work outside the bounds of private and government health insurance, charging a fixed monthly fee in exchange for unhurried office visits, communication outside office hours, and other benefits such as maintenance drugs at no charge and reduced fees for lab diagnostics.

My forty-five minute follow-up visit with Dr. Macallan was efficient and productive. Blood work and imaging ordered. Prescriptions discussed. Recommendations made. All in a genial, collaborative mode.

What distinguishes a productive visit from the usual medical charade is not speed, but signal-to-noise ratio. This one had a high signal. We worked through a prioritized list rather than ricocheting between whatever happened to scroll into the electronic chart that morning. The lung nodule, iron status, kidney function, gout, and surveillance imaging were all addressed explicitly, not waved away with the clinical equivalent of “we’ll keep an eye on it.”

That alone puts Dr. Macallan several standard deviations to the right of the mean.

Ironic, Isn’t It?

Iron was the one area where we politely disagreed. My ferritin is now comfortably normal after IV Venofer in the fall, my hemoglobin sits at a respectable 14.7, and iron saturation—long my trouble spot—has finally climbed into the high-20s. From his perspective, that’s case closed with twice-yearly monitoring. From mine, iron saturation remains the more sensitive canary in the coal mine, especially in the context of CKD and endurance hiking. We compromised in the adult way: data will decide. No sermonizing, no appeals to authority, just labs at defined intervals and reassessment if trends misbehave.

Chronic Gout

Gout, on the other hand, required less philosophical discussion and more mechanical clarity. Between the October flare, rat-bite erosions on X-ray, and a now-palpable tophus over the MTP joint, the diagnosis has matured from “annoying episodic guest” to “chronic housemate.” That moves urate-lowering therapy from optional to inevitable.

Where we did have a substantive exchange was dosing. The initial plan had me starting allopurinol at 300 mg daily, which may be expedient, but expedience is rarely my preferred design constraint at age 79 with stage 3 CKD. Package labeling and common sense both still recommend starting low and titrating upward in patients with reduced renal reserve. I made the case—calmly, with citations—that I was not interested in discovering idiosyncratic hypersensitivity syndromes the hard way.

To his credit, Dr. Macallan agreed immediately. The prescription was rewritten for 100 mg tablets so I can start at 50 mg daily and ramp up deliberately, with colchicine as flare prophylaxis during the transition. Slower? Yes. Safer? Also yes. I’ll trade speed for margin every time.

Imaging

CTA

Imaging required similar triage. A CTA (computed tomography angiogram — a fancy CT scan to observe coronary arteries) had been proposed as “routine CAD surveillance,” which is one of those phrases that sounds reassuring until you interrogate it. My last cardiac CT in late 2023 showed only mild, non-obstructive plaque—nothing that justifies contrast, radiation, and renal stress on a two-year cadence. When I asked the obvious question—what clinical question is the CTA meant to answer?—the answer turned out to be: none in particular. We postponed it until 2028, or sooner if symptoms develop, which is how evidence-based medicine is supposed to work.

Cancer Screening Lung CT Scan

The lung CT was more nuanced. A 3 mm incidental nodule, stable and explicitly labeled benign on a June 2025 scan, does not justify aggressive follow-up. Nor do I meet Medicare’s criteria for annual low-dose lung cancer screening: I’m too old, and I quit smoking in 1989, back when shoulder pads were still a thing. Bell-bottoms were out by then, but I digress. That said, I will self-pay for a single non-contrast diagnostic chest CT—$159 at Advent—purely to close the loop on my own terms. My choice there. CMS need not be involved.

Abdominal MRI

The MRI, finally, is the easy one: routine surveillance of known pancreatic IPMNs per GI recommendations, kidney-safe, contrast-free, and uncontroversial, a lasting legacy of my consultation with the Irascible Dr. Scrooge, my gastroenterologist.

Both scans are scheduled on January 26, a week from today.

Lab Results — Not Too Bad

The follow-up labs tell a reassuring story. Kidney function is stable, with no albuminuria. A1c sits at 5.5. Lipids are boring in the best possible way. The uric acid, oddly, remains at 4.1 mg/dL—low enough to confuse anyone who believes single lab values are Platonic truths. Between post-flare physiology, SGLT2-mediated uricosuria from dapagliflozin, and the well-known noise introduced by creatine supplementation, I’m not losing sleep over it. Crystals don’t dissolve because one blood draw had a good day.

Dr. Macallan’s comment about the uric acid level was, “You are already at the uric acid goal now so you could just stick with 50 mg allopurinol indefinitely for right now. And if it changes on future labs we have room to increase it.”

All told, this was not an “annual physical” so much as a systems check with intent. No drama, no heroics, no unnecessary scans ordered to appease an algorithm. Just a thoughtful, collaborative recalibration—exactly what direct primary care promises, and too rarely delivers.

Hernia Update

One loose end from late 2025 deserves closing, if only to reassure readers who assume that abdominal surgery at 79 consigns one to a lifetime of reclining furniture and elastic waistbands.

I am now six weeks out from a robotic mesh repair of a right inguinal hernia, and recovery continues exactly as advertised. At my two-week postoperative visit with my surgeon, Dr. O, in late December, the exam was entirely unremarkable: incisions healing cleanly, no evidence of recurrence, no infection, no complications worth a footnote. What discomfort existed then was described—accurately—as soreness rather than pain. That distinction has only sharpened with time.

Functionally, I’ve been walking , using the treadmill at the Y, and doing light dumbbell work with some pussy dumbbells at home. Bowel function normalized quickly with minimal pharmacologic persuasion. The brief and mildly disconcerting episode of postoperative testicular wanderlust resolved on its own, as these things usually do, without drama or intervention.

Minor Frustration

The only real frustration is one of restraint. I remain under weight restrictions for another couple of weeks—no deadlifts, no heavy benching, nothing that treats the core like an adversary rather than a collaborator. The surgeon’s guidance was explicit: cardio, running, cycling, stair work, swimming, and light resistance are fine; maximal effort lifting can resume at the end of January or early February.

That date is circled.

When the green light comes, I’ll ease back into the barbell work deliberately, not heroically. Deadlifts, presses, and squats will return, but they’ll do so under adult supervision—mine. The absence of pain, the stability of the repair, and the overall smoothness of recovery have done nothing to dampen my eagerness to get back under load. If anything, the enforced pause has sharpened it.

For those keeping score, this is what “successful surgery” looks like: no lingering symptoms, no chronic pain narrative, no cascade of follow-ups, and a clear path back to normal activity. Boring, in the best possible way.

Next week: living with allopurinol, watching urate like a hawk, planning my post-surgery workout routines, and continuing my ongoing experiment in aging without surrendering agency. Stay tuned.

And that’s a wrap…

So where does that leave things this week?

On the personal front, the answer is mercifully boring. Metabolically steady. Renally stable. Iron finally behaving itself. Gout has crossed the Rubicon from episodic nuisance to managed chronic condition, with a plan that favors margin and method over macho dosing. Imaging has been trimmed back to what answers actual clinical questions rather than what placates algorithms. The hernia repair is holding exactly as engineered, and the only lingering annoyance is temporary prohibition from loading a barbell by professionals whose livelihoods depend on patients not doing anything spectacularly stupid.

Beating That Dead Horse Again

Layered on top of that mundane systems check was a familiar intellectual exercise: watching GLP-1 receptor agonists continue their steady evolution from useful metabolic tools into something closer to a secular sacrament. Obesity treatment, cardioprotection, cancer prevention, longevity—if you squint hard enough, these drugs now appear capable of absolving poor diet, bad sleep, and possibly original sin. What remains conspicuously scarce in much of this literature is proportionality: effect sizes in context, confounders treated seriously, and conflicts of interest examined as more than a box-checking exercise.

None of this negates the genuine utility of GLP-1s. I am, after all, still taking one. What it does underscore is the widening gap between measured benefit and marketing ambition—a gap increasingly filled by eligibility studies masquerading as policy guidance, breathless extrapolation, and a scientific establishment that seems oddly comfortable letting industry set the narrative tempo. That discomfort, more than the drugs themselves, is what keeps earning repeat visits to Bullshit Corner.

Keeping It Under Control

Taken together, this week wasn’t about breakthroughs. It was about boundary setting: knowing when to accept a drug, when to defer a scan, when to titrate slowly, and when to ask the most basic question in medicine—what problem are we actually trying to solve? Aging well is less about chasing every new promise and more about managing known risks without outsourcing judgment.

Next week: the allopurinol ramp, continued urate voyeurism, and a cautious return under the bar once surgical mesh is no longer the weakest link in the system. There will almost certainly be another GLP-1 miracle paper to read, annotate, and file under interesting, but calm down.

Until then: stay upright, stay skeptical, and remember—not too bad remains a vastly underrated clinical outcome.

Peptide Purgatory chronicles one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia while reading policy papers. So, ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: Do You Qualify for a GLP-1? appeared first on The Nittany Turkey.

A familiar progression takes place. An idea becomes a cause. The cause becomes a movement. The movement hardens into an institution. And the institution, no longer tethered to its original purpose, eventually devotes most of its energy to preserving itself. Not because anyone planned it that way, but because the incentives quietly changed. The mission stopped being the point; it became the justification.

Layered onto this progression is a less charitable but reliably accurate observation about hierarchies: people tend to rise because they were good at what they used to do, not because they are suited to what they are promoted into. Over time, authority accumulates in the hands of people who are earnest, busy, and increasingly detached from the system they oversee. Those who truly understand how things work either burn out, disengage, or learn to keep their mouths shut.

When these two forces intersect, the outcome is predictable. Governance becomes a mere performance. Process replaces judgment. Narrative management displaces accountability. And the most dangerous thing a competent person can do is describe reality too bluntly.

What follows is an allegory. It is not about any one organization. It is about what happens when entropy is mistaken for growth, and continuity is confused with health.

The Lighthouse

The harbor had a problem: ships were running aground.

The solution was simple and elegant—a lighthouse. Its founders placed it where it mattered, staffed it with people who understood tides, weather, and the coastline, and maintained it with just enough discipline to keep the light burning. For years, it worked. Ships arrived safely. Wrecks were rare. No one gave much thought to governance, because the job was getting done.

This success proved unsettling.

Surely something so important could not be left to a single light and a handful of keepers. Modern harbors were complex systems. A lone beam, however effective, felt insufficiently sophisticated.

And so, in the name of safety and professionalism, government created a Harbor Authority.

The Authority concluded that while the lighthouse had historical merit, it merely indicated danger; it did not actively prevent it. Ships could ignore the light. Captains could misinterpret it. Some even claimed decades of safe passage without assistance and resented the implication that guidance was necessary at all.

Overthinking into Entropy

The solution was pilots.

Harbor pilots would board incoming vessels and take control during the final approach. To ensure consistency, the Authority established training programs, certification standards, and continuing education requirements. It formed committees to define edge cases. Subcommittees refined the definitions.

The pilots unionized.

They viewed this as progress. Collective bargaining ensured standardized compensation, grievance procedures, and predictable schedules. It also ensured that pilot availability would now depend on contract language rather than tides or weather, but they considered this an acceptable tradeoff.

By this point, the Harbor Authority could rightly claim to have transformed a simple navigational aid into a comprehensive maritime safety ecosystem.

Forgetting the original Mission

Somewhere along the way, however, the lighthouse became a legacy asset.

They trimmed its budget, deferring maintenance. The keeper retired and was not replaced; after all, safety was now handled by professionals. The light still worked—most of the time—but it no longer merited discussion. It appeared on inventories, flagged for “future modernization.”

Ships continued to arrive.

Some arrived safely. Some did not. When groundings occurred, investigations focused on pilot workload, certification protocols, and whether captains had complied with Harbor Authority advisories. No one asked whether the light had been on.

A Legacy Preserved

Community forces commissioned a study. It concluded that while the lighthouse remained a valued symbol of the harbor’s heritage, modern safety depended on coordination, process, and stakeholder engagement. The report recommended clearer messaging to discourage reliance on outdated navigational methods.

The lighthouse was not mentioned again.

In time, responsibility for the lighthouse passed to the Historical Preservation Society. The Harbor Authority framed this as a victory. The light would be preserved, celebrated, and protected from the wear and tear of purposeful use.

At first, the Society was staffed by volunteers who meant well but struggled with basics—staffing the gate, managing parking, keeping the hours straight. Eventually, as often happens, the volunteers became the board. The board formalized itself creating committees, writing rules, and measuring compliance.

Entropy Redux

The Society elected unopposed warm bodies to Board seats. Elections became procedural. When someone did step forward, it was usually after being assured that they would neither need to answer difficult questions nor agree to significant changes. The Society emphasized stability and celebrated continuity for continuity’s sake. They defined “experience” narrowly enough that only familiar faces qualified.

The lighthouse became immaculate.

It received a coat of fresh paint. A committee documented its history. Another committee scheduled tours. Yet another installed plaques. The Society published reassuring statements about stewardship and tradition. Any suggestion that the lighthouse’s function might deserve renewed attention was gently deflected as unnecessary, disruptive, or nostalgic.

Ships, meanwhile, continued to run aground.

When that happened, the Harbor Authority’s explanations were thorough and bloodless. They would review procedures, refine interfaces, and clarify messaging. With their entropic roles cemented by meaningless elections, no one suggested climbing the tower to see whether the light was still burning—or whether anyone remembered how to tend it.

The End

By the end, the harbor had everything except what it was created to protect. There were boards without challengers, elections without choices, caretakers chosen for their eagerness rather than their aptitude, and a lighthouse preserved so carefully that it was no longer allowed to matter. The system endured. The mission did not. What no one could quite explain was how a system built entirely from good intentions, reasonable decisions, and accumulated success had become so indifferent to the simple task that once defined it.

Organizations do not fail when the light goes out—they fail when success convinces everyone it no longer needs tending.

If you want some further reading about organizational entropy, I have written a paper that relates ham radio award nets to thermodynamic systems. Sounds boring, I know, but if you wish to dive into it, you can download it here.

The post Organizational entropy appeared first on The Nittany Turkey.

This week’s issue covers worthless government research, along with claims of GLP-1s superiority over aspirin for colon cancer prevention. Crowing about the new inverted food pyramid released jointly by RFK Jr. and the Beef Council is all the rage these days, so we give it a go in a BULLSHIT CORNER EXTRA!

I’ll give you a break from my personal health issues until next week. My visit with Dr. Macallan went well, leaving me lots of homework — lab tests, cat scans (you know the vet joke, right), and an MRI. I’ll report on those as results arrive.

But for now, the Government is here to provide 19 years of clarity — or NOT!

Nineteen Years to Prove Gravity Exists

There are scientific endeavors that expand human knowledge.
There are others that merely document the obvious at exquisite expense.

Today’s entry in the latter category is a little-noticed NIH observational study that began in 2007, is still technically alive in 2026, and has spent nearly two decades “phenotyping” overweight and obese adults to determine their physical and behavioral traits.

Translation:
Are fat people different? And if so, how hard can we stare at them until the answer blinks first?

The Study That Would Not Die

The protocol reads like an inventory checklist for a biomedical Home Depot:

• Resting metabolic rate
• 24-hour energy expenditure
• Doubly labeled water
• Hormone panels
• Taste testing
• Sleep monitoring
• Circadian rhythm analysis
• Fat and muscle biopsies
• Neurocognitive testing
• Personality assessment
• Mood evaluation
• Pain perception
• Occupational therapy interviews about how subjects feel about their bodies

Short of interrogating participants about their childhood pets, nothing was left untouched. If adipose tissue could have been waterboarded, it probably would have been.

And all of this was done in the service of answering a question whose answer has been painfully obvious for decades:

Obesity is not a failure of character. It is a biological state.

But apparently, saying that out loud without nineteen years of isotope studies was considered premature.

The Control Group Tells the Story

The real comedy appears in the eligibility criteria.

Lean controls were excluded if they had ever been obese.
Obese participants were excluded only if they were too impaired to complete the testing.

So we end up comparing:

• Lean people who have never struggled metabolically
  versus
• Obese people selected specifically because they are metabolically burdened but still functional enough to endure NIH boot camp.

That’s not neutral science. That’s selection bias with a clipboard.

If you were trying to design a study to make obesity look like a permanent personal defect rather than an adaptive metabolic condition, this would be a solid first draft.

What Did We Learn?

After nearly two decades, the conclusions will look something like this:

• Metabolism differs.
• Hormonal signaling differs.
• Energy expenditure is not dramatically lower.
• Food reward signaling differs.
• Cognitive capacity is normal.
• Behavior adapts after physiology changes, not before.

In other words:

People with obesity are biologically different in predictable, measurable ways that precede and perpetuate weight gain.

This is nothing new. It is merely confirmation.
And it was already obvious to patients, clinicians, and anyone paying attention before the first Bod Pod was powered on.

The Cost of Studying the Obvious

Let’s talk about cost, because this is not an academic parlor game.

Nineteen years of:

• Inpatient metabolic ward stays
• Imaging
• Biopsies
• Specialized staff
• Data management
• Repeated measures for the sake of “robustness”

This was not cheap. This was hundreds of millions of taxpayer dollars spent documenting what obesity patients had been told was their fault the entire time.

While this study lumbered along:

• Patients were denied effective pharmacotherapy
• Insurers refused coverage for obesity treatment
• Physicians were encouraged to prescribe “lifestyle modification” as a cure-all
• Policy makers hid behind the phrase “personal responsibility”

All while the NIH quietly accumulated data proving that responsibility was never the limiting reagent.

Who Was This For?

Not patients. They already knew.

Not clinicians. The competent ones moved on years ago.

Not insurers. Biology costs money.

Not policy makers. Biology implies obligation.

This study existed primarily for:

• Grant renewals
• Academic careers
• Review articles
• And the illusion of progress without the inconvenience of action

It allowed the system to say, “We’re still studying this,” long after the moral justification for delay had expired.

The Bitter Irony

The final insult is that Big Pharma resolved the debate faster than academia. Just follow the money.

GLP-1 and dual-agonist drugs did more to legitimize obesity as biology in five years than this study did in nineteen. Once weight loss became reproducible, durable, and mechanistically explicable, the behavioral blame narrative collapsed overnight.

Funny how that works.

The Takeaway

This study will eventually conclude that obesity is complex, multifactorial, and biologically mediated.

Which raises the only question that matters:

Why did it take nineteen years and a small fortune to admit what patients were punished for knowing all along?

Obesity was never a mystery.
It was an inconvenience.

And this study didn’t solve it.
It just made ignoring it look scientific.

So that’s this week’s installment: nineteen years of federally funded confirmation that biology exists, a GLP-1 hype cycle already eyeing colonoscopy replacement, and yet another ritualized update to dietary guidelines that even their authors admit nobody follows. The common thread is not ignorance, or even malice. It’s inertia dressed up as progress. Studying what’s obvious. Announcing what’s premature. Reissuing what’s failed.

Next week I’ll return with lab numbers, scan results, and whatever new acronyms Dr. Macallan has added to my to-do list. Until then, rest assured: gravity still works, metabolism still matters, GLP-1s have not yet cured democracy, and the government remains hard at work proving all of this on a five-year cycle. Same time next week. Same purgatory.

Peptide Purgatory chronicles one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia while reading policy papers. So, ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: Why We’re Fat appeared first on The Nittany Turkey.

This week, we further observe Big Pharma’s unfettered market expansion of GLP-1 drugs into all aspects of our daily lives. Pretty soon, there’ll be GLP-1 fuel additives for your car and maybe a GLP-1 drywall joint compound — pricey, but will work wonders for fuel economy and a smooth drywall job. (Your house is getting a little chubby, too — admit it!) But on the medical front page today, we learn that GLP-1s are just what the doctor ordered for your sanity. You can’t make this shit up!

We’ll wrap up the week with Bullshit Corner, where we cast a cynically humorous eye on the anthropological side of GLP-1 receptor agonists.

So, buckle your seatbelts… Nah, this won’t be a rough ride!

GLP-1s: Now Treating Your Demons, Your Addictions, and Possibly Your Sump Pump

There was a time, not that long ago, when GLP-1 receptor agonists were modest little diabetes drugs. They lowered glucose, slowed gastric emptying, nudged insulin along, and stayed politely in their lane.

That era is over.

According to the latest breathless reporting from Healio, GLP-1s now appear poised to cure addiction, depression, dementia, suicidality, and whatever is rattling around in the human psyche that still lacks a billing code. I am only mildly surprised they stopped short of claiming improved marital harmony and leak-free basements.

Let’s be clear: there is real biology here. GLP-1 receptors exist in the brain. They intersect with dopamine pathways, reward circuits, the HPA axis, inflammation, and neurogenesis. None of that is crackpot science. The brain-gut axis is real, and anyone pretending otherwise is still stuck in a 1997 endocrinology textbook.

But what we are witnessing now is something else entirely: therapeutic scope creep fueled by marketing gravity.

The Addiction Angle: Interesting, Preliminary, and Already Overhyped

Animal models. Retrospective database analyses. Small human trials. Signals suggesting reduced alcohol cravings, fewer opioid overdoses, less nicotine use. All genuinely interesting.

Also: not remotely sufficient to declare GLP-1s the pharmacologic equivalent of Alcoholics Anonymous, cognitive behavioral therapy, and social support rolled into one weekly injection.

Even the psychiatrists quoted in the piece quietly wave the yellow flag, warning that substance use disorders are heterogeneous, messy, and stubbornly resistant to single-target pharmacology. Translation: anyone selling this as a universal addiction cure is either naïve or has a sales quota.

Depression and Mood: Correlation Is Not Redemption

Weight loss improves mood. Improved glycemic control improves energy. Reduced inflammation improves… a lot of things. None of that requires a revolutionary psychopharmacologic explanation.

Yet here we are, floating phrases like “mood stabilization” and “direct CNS effects” as though we’ve just reinvented SSRIs, minus the decades of trials and inconvenient side-effect disclosures.

The fact that one study hints at reduced suicidality while another hints at increased suicidal ideation should probably inspire caution, not a victory lap. The FDA’s “we found no association” is not the same thing as “problem solved.”

Cognition and Dementia: Hopeful, but Calm Down

Yes, GLP-1s may reduce neuroinflammation. Yes, hippocampal neurogenesis is intriguing. Yes, observational data suggest lower Alzheimer’s diagnoses in diabetics on semaglutide.

No, this does not mean we have stumbled upon a dementia-preventing fountain of youth that just happens to retail for $1,000 a month and is intermittently unavailable at CVS.

Even the Alzheimer’s Association is telling people, politely but firmly, do not ask your doctor for this. Which in modern medicine is roughly equivalent to shouting into a hurricane.

The Pattern Is the Problem

This is the same arc we’ve seen before:

1. Legitimate metabolic drug
2. Off-label curiosity
3. Epidemiologic signal
4. Media amplification
5. Pharma-funded trials “exploring potential benefits”
6. Influencers declaring victory
7. Insurance premiums quietly rising in the background

At some point, someone will seriously propose GLP-1s for “subclinical dissatisfaction with life,” and a white paper will be commissioned.

Final Thought Before We Start Fluoridating with Tirzepatide

GLP-1 receptor agonists are powerful drugs. They work because metabolism is foundational to human physiology. When you touch energy balance, inflammation, insulin signaling, and reward pathways, ripple effects are inevitable.

But inevitable effects are not the same as universal cures.

The danger here is not that GLP-1s are doing too much. It’s that we’re asking them to do everything, because medicine desperately wants a clean, injectable solution to problems that are messy, social, psychological, and structural.

If this keeps up, the next Healio headline will read:

“GLP-1s Show Promise in Treating Existential Malaise; Trials Ongoing.”

And honestly, at that point, I might sign up.

Peptide Purgatory chronicles one old fart’s ongoing experiment with GLP-1s, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia while reading policy papers. So, ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: Let’s All Take GLP-1s appeared first on The Nittany Turkey.

I’m a few days late with my 2025 swan song, but I didn’t have a lot to say about the Pinstripe Bowl that you hadn’t already read somewhere else.

Also, I know it is considered sacrilege among the Sanguinarians, but I’m not all ga-ga about Terry Smith and I don’t feel that Pat Kraft missed the boat by not hiring him for the permanent job. I’m confident that Matt Campbell is the right guy for the job.

Why? Because he’s the guy who got it. Frankly, we do not know how anyone will do until they’ve been in the job for a cycle or two, and until then, one’s as good as the other. And fans, particularly those who never played or coached the game, but only know how to bet on it, are idiots, so the first false step by Campbell will make him the target of vacuous, unfounded Facebook scorn.

He made the right move keeping Terry around to ease his transition. Cheap insurance against a fan and player revolt. (Fans and players are such insecure critters — take away their security blankie and they crumble into a paranoid mound of Jell-o). Associate Head Coach? WTF does that mean? Amorphous duties no doubt. Stick around, Terry, and we’ll find something for you to do. Four years? We’ll see.

Oh, yeah, the Pinstripe Bowl. Penn State won 22-10. Grunkemeyer performed well, prompting many Sanguinarians to anoint Grunk as the starter right here and now before someone else snatches him up. Meanwhile, surprise, surprise, Dani Dennis-Sutton surprised us all by opting-IN. In this day of “I don’t give a shit bout no bowl game”, that’s a mark of character. Clemson looked like shit, as their receivers dropped almost as many passes as they caught.

So, the transfer portal opens on January 2. Chinese checkers ahead. Round and round she goes, where she stops, nobody knows. Sanguinarians want Beau Pribula to come back to Penn State. Lemme ask you — how the hell do you complete your plan of study when you transfer to a new school every year? (That was tongue-in-cheek; to quote the inimitable ex-Buckeye Cardale Jones, “I don’t come here to play classes.”)

But the big, big news, especially for Sanguinarians, is D’anton Lynn’s projected hire as Matt Campbell’s Defensive Coordinator. Lynn, an ex-Nittany Lion cornerback currently coaching at USC, meets the Sanguinarian Seal of Approval. After coaching in the NFL, Lynn moved to UCLA in 2023, then moved on to USC for the 2024 and 2025 seasons. Seems to hop around a lot. Will he stick around at Penn State for any length of time? Penn Stater or no, Lynn is likely to stick around until a better offer comes along. That’s they way of college football these days.

We don’t know nothin! We don’t know who will be playing next year and I won’t be speculating about it here.

So, I’ll wish you all a Happy New Year!

The post That’s a Wrap! appeared first on The Nittany Turkey.

We have three stories for you this week. First, the FDA has approved an oral version of Wegovy, to expand their weight loss hobbyist market to the needle-squeamish crowd. Then, sticking with the oral cavity, we examine claims of people losing teeth due to a syndrome dubbed “Ozempic Mouth.” For our self-centered sub-feature, I’ll give you results of my hernia surgery follow-up, and maybe even show you an internal photo taken by the da Vinci robot. Finally, Bullshit Corner wraps up the week with a sidelong glance at what fat-loss hobbyists are calling GLP-3s.

1) Wegovy Goes Oral: Novo Nordisk Tries to Take the Needle Out of the Conversation

Novo Nordisk has scored a legitimate milestone with FDA approval of oral Wegovy, the first GLP-1 pill formally indicated for weight loss. This is not influencer vaporware or compounding-pharmacy alchemy. This is real FDA approval, backed by trial data.

The once-daily 25 mg semaglutide pill delivers average weight loss in the low-to-mid teens, just shy of injectable Wegovy. Among adherent patients, results push higher, with roughly a third hitting the psychologically important 20% threshold. That is respectable, even impressive, for a pill.

Of course, this is not a “take it whenever” tablet. It must be swallowed on an empty stomach, with minimal water, followed by a mandatory waiting period before food, drink, or other medications. In other words, it retains the same finicky morning ritual that made Rybelsus so beloved by people who enjoy setting timers before coffee.

Still, this matters. Pills scale differently than injectables. They are easier to prescribe, easier to ship, and psychologically easier for patients who still recoil at needles. Novo’s introductory pricing, at least on paper, undercuts the injectable GLP-1s, though nobody should confuse launch discounts with durable affordability.

This is a format win, not a knockout. Eli Lilly still owns the efficacy crown with tirzepatide. But Novo just expanded the battlefield, and that alone will reshape prescribing patterns.

2) “Ozempic Teeth”: Dry Mouth Discovers Social Media

This week’s contribution to the GLP-1 Body Parts Cinematic Universe comes courtesy of the Internet’s newest diagnosis: “Ozempic teeth.”

The claim, amplified by viral anecdotes, is that GLP-1 drugs are causing gum disease, tooth decay, and bad breath. MedPage Today did the unglamorous but necessary work of calling an actual physician, who responded with a profoundly boring explanation: dry mouth and dehydration.

GLP-1 receptor agonists can reduce appetite and thirst. Less eating often means less drinking. Reduced saliva follows. Dry mouth is a well-known risk factor for gum irritation, dental caries, and halitosis. None of this is novel, exotic, or specific to semaglutide. It also happens with antidepressants, antihistamines, blood pressure meds, CPAP use, aging, and breathing through your mouth like a golden retriever.

The more severe cases highlighted online appear to cluster among people who are unsupervised, underhydrated, vomiting, or generally inattentive to basic self-care. That is not a pharmacologic mystery. That is neglect.

The fix, such as it is, will not trend on TikTok: drink water, eat adequately, maintain oral hygiene, and tell your dentist what medications you take. If GLP-1s truly caused spontaneous dental collapse, orthodontists would be retiring early.

“Ozempic teeth” is not a syndrome. It is a hashtag in search of a mechanism.

3) Meanwhile, Back at the Abdomen: Hernia Follow-Up and the Tyranny of Light Weights

For the self-absorbed portion of the column, a brief surgical update. Above is an internal picture of the polypropylene hernia repair mesh as it was deployed on December 9, when I had the da Vinci Xi robotic laparoscopic surgery.

So, I’m going on three weeks out from the robotic mesh repair of a right inguinal hernia. Last Tuesday, I had my postoperative follow-up with Dr. O, the surgeon who performed the master work. The verdict: boringly positive.

No recurrence of the groin lump, no infection, no drainage, no drama. Mild residual soreness at the incision sites, particularly the largest one, which is apparently normal and not a harbinger of mesh catastrophe. Bowel function returned on day three with pharmaceutical encouragement, after which my colon resumed its usual authoritarian efficiency.

Activity-wise, I’ve been walking a couple of miles daily, using the treadmill at the YMCA, and performing seated exercises with my humiliating purple, five-pound dumbbells. Now, the surgeon has cleared me for cardio, swimming, cycling, elliptical work, stair machines, and even squats—provided I behave myself and keep the load reasonable.

The bad news is that deadlifts remain verboten until late January or early February. The almost good news is that I am allowed to lift up to 20 pounds total, no more than 10 pounds per hand, but only if I refrain from engaging my core like an idiot. In other words, I am temporarily training like someone who writes op-eds instead of lifting heavy things.

The official plan is simple: continue progressive activity, avoid stupidity, and call the doc if anything new, painful, or anatomically surprising occurs. I’ve been discharged from surgical care, which is medical shorthand for “don’t do anything dumb and make us meet again.”

Peptide Purgatory chronicles one man’s ongoing experiment with GLP-1s, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia while reading policy papers. So, ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: WTF is a GLP-3? appeared first on The Nittany Turkey.

This is one of those games that technically exists.

Penn State and Clemson will meet at Yankee Stadium on Saturday in a noon kickoff that feels less like a sporting event and more like an obligation. It’s the football equivalent of attending a distant cousin’s third wedding. The Bad Boy Mower Pinstripe Bowl presents us with a previously proud Big Ten program and a formerly proud ACC program. They both arrive with streaks of ill fortune, lost momentum, waning enthusiasm, and barely recognizable personnel.

IF they arrive. See Da Wedda below. In the paraphrased words of Donald J. Trump, “There’ll be so much snow, you wouldn’t believe!”

Clemson Will Freeze Their Tuchuses

Penn State is somehow favored by 2.5 points. But this doesn’t mean they’re that much better than Clemson. This is either a triumph of advanced analytics or proof that Vegas has decided to lean into surrealism. Given the current state of affairs, the line might as well be based on astrology, moon phases, or the relative quality of the teams’ travel snacks. Or maybe they picked the team more likely to not succumb to frostbite.

Who Gon’ Be Dere

Last I heard, assuming he can find Yankee Stadium in the snow, Terry Smith will be the man with the headset on the sidelines. This is a nice tribute to a guy who carried the team on his shoulders after James Franklin got his ass canned mid-season. It is also an appeasement for fans who know nothing about running a football team — one last time to give them what they want before the Matt Campbell Era kicks in.

As for the players, this is where the fog becomes impenetrable. Opt-outs, portal entries, injuries, and sudden existential clarity have reduced both rosters to something resembling spring practice squads. Depth charts are aspirational documents at this point. If a player’s name appears on the two-deep, it simply means he has not yet formally declared his intention to disappear. I know this: you won’t be seeing Nick Singleton or Kaytron Allen. As for the million dollar receivers, who knows? Those of us who have seen them screw up every game this season might not WANT to see them — ever again.

No One Knows

Internet previews have reflected this uncertainty with stunning honesty by saying almost nothing. Matchup analysis is replaced with vague observations about “young guys getting opportunities” and “culture moments,” which is code for we have no idea who is playing or what they can do. Any statistical comparison is rendered meaningless when half the contributors are no longer contributing.

Predictions are all over the map.

How Long Will Bowls Be Viable?

This is the future of the non-CFP bowl season. As the playoff expands and hoovers up oxygen, relevance, and most of the good teams (sorry, Notre Dame), the rest of the bowl ecosystem is left staging glorified exhibitions for television inventory. Some high-profile teams who just missed the playoffs have opted out of the bowl picture completely. Yes, Notre Dame was the first to take their ball and go home, although their withdrawal required Papal authorization via an Encyclical to Bishop Rhoades. What remains when the good teams and the good players are gone? Lots of time watching commercials and asking, “Who the hell was THAT?”

Fans are asked to spend real money to watch teams composed largely of freshmen and placeholders, while broadcasters insist this still matters because it has always mattered.

It no longer does.

And yet, the game will be played. Or maybe it will be mercifully called on account of blizzard.

Once the field is plowed, Penn State will run a simplified offense, lean on whatever version of its offensive line exists that day, and hope defensive effort compensates for schematic minimalism. Clemson will attempt to do the same, buoyed by the vague notion that its logo once terrified people. Half-empty Yankee Stadium will look indifferent, the Bronx will not notice, and college football will march on without pausing to explain itself.

Da Wedda – Bomb Cyclone!

Well, sheee-it, this is where it damn well gets interesting! Welcome to da City PSU fans, the few of you who made the trip. Most of those who will eventually show up rode the subway, I hope because our friends at NOAA have given us the following hopeful bit of news.

…WINTER STORM WARNING REMAINS IN EFFECT FROM 4 PM THIS AFTERNOON TO 1 PM EST SATURDAY…

WHAT… Heavy snow expected. Total snow accumulations between 6 and 9 inches.
WHERE…Portions of southern Connecticut, northeast New Jersey, and southeast New York.
WHEN…From 4 PM this afternoon to 1 PM EST Saturday.
IMPACTS…Roads, and especially bridges and overpasses, will likely become slick and hazardous. Visibilities may drop below 1/4 mile due to falling and blowing snow. Travel could be very difficult. The hazardous conditions could impact the Friday evening commute.
ADDITIONAL DETAILS…The period of heaviest snowfall (1-2″/hr) will occur between 6pm and midnight, making travel very difficult.
PRECAUTIONARY/PREPAREDNESS ACTIONS… If you must travel, keep an extra flashlight, food, and water in your vehicle in case of an emergency. Check local Department of Transportation information services for the latest road conditions. Persons should consider delaying all travel. If travel is absolutely necessary, drive with extreme caution. Consider taking a winter storm kit along with you, including such items as tire chains, booster cables, flashlight, shovel, blankets and extra clothing. Also take water, a first aid kit, and anything else that would help you survive in case you become stranded.

And so, mateys, anything goes! Who knows what the field will look like after 3-6″ of snow over 21 hours, and who knows what kind of swirling winds will ruin passing and kicking games. WHO KNOWS, ALREADY?!?!

The snow should end in the morning, and the high will be only 33F, which will quickly drop off to a low of 18. It will be a gloomy winter day in da Bronx.

Da Bottom Lion

You’ve reached the final Official Turkey Poop Prognostication of the 2026 season. Hip hip HOORAY! This one will be even more out of my ass than usual. I know nothing. Nothink!

But a prediction is required, because tradition demands one even when logic refuses. I’ll play it straight. Penn State favored by 2.5 with an over/under of 48. Good luck getting to 48 when you can’t find the field under the snow. But the playful freshman will have great fun frolicking in the winter wonderland making snow angels on the field after the game. Meanwhile, any fans stupid (read loyal) enough to show up, will need a propane torch to unfreeze their balls from the Yankee Stadium seats — and that’s just the women!

I’ll go with Penn State 20, Clemson 17. Although Clemson 20, Penn State 17 is also a possibility. So is 3-2 in favor of the snow gods.

Analysis

I’m thinking I should bow out for the year picking Penn State on top. Not because Penn State is better, more prepared, or more motivated, but because someone has to win, and Penn State is favored by 2.5 for reasons known only to the universe and the betting markets. Expect missed tackles, conservative play-calling, and at least one moment where you ask aloud, “Who is that guy?”

Which, in its own way, perfectly captures the modern bowl experience.

And this game — THIS GAME — is symbolic of Penn State’s achievement this year. It is not the Toilet Bowl, but it could be the Bad Boy Frozen Balls Bowl, which is even worse. It’s sure as hell not the warm weather or indoor experience we ASS-umed would be our destination at season’s outset. Not by a longshot. I have only two words to utter about this venue, this game, and this season:

It suuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuucks!

I’ll return after the game for a retrospective on the Snow Bowl and the 2026 season. I’ll try to keep it down to two words or so.

The post Bad Boy Pinstripe Perplexity appeared first on The Nittany Turkey.

Back at the beginning of my Mounjaro therapy, I wrote about the various devices I use to track my progress: blood pressure monitor, blood glucometer, and smart scale. Today, we re-examine the smart scale, which I consider the most cost-effective purchase of all, in the context of today’s upscale expanded smart scale market. Do you really get that much more for $200 than for $20?

Scale Wars: How a $18 Smart Scale Survived a $360 Marketing Coup

I bought my RENPHO Smart Scale in 2020 for eighteen dollars. It wasn’t a lightning deal, a rebate stack, or some “act now” nonsense—just a plain $18 purchase that showed up, synced to an app, and did its job.

Five years later, it’s still doing its job. Although Amazon is now selling it for $29.99, it is still an excellent value.

Let’s establish the ground rules immediately. The only absolute value I care about from any bathroom scale is weight. Everything else—body fat percentage, muscle mass, visceral fat, metabolic age—is derived, estimated, and highly sensitive to hydration, timing, and algorithmic mood swings. Those numbers can be amusing and occasionally useful for watching trends, but they are not truth. They are entertainment with decimal places.

To be sure the Renpho wasn’t lying to me about the one number that matters, I checked it against my ancient Health-o-meter balance scale, a brutally honest chunk of steel from the era when scales didn’t speak Bluetooth or offer lifestyle advice. The Renpho tracked accurately, within trivial variance. That was good enough for me.

And that’s where things stood—until the ads started coming.

The Marketing Blitz

Out of nowhere, my feeds were flooded with promotions from Hume Health, pushing a $360 “smart scale.” The price was always crossed out, always “on sale,” always urgent. The messaging was unmistakable: this wasn’t just a scale, it was insight. It was AI. It was metabolic intelligence. Ownership was framed not as a purchase, but as a statement of seriousness.

Then I noticed something else.

RENPHO, long known for selling perfectly serviceable smart scales for pocket change, had quietly entered the same rarified air with a roughly $200 product of its own. Same general category. Similar promises. Less preaching.

That coincidence wasn’t accidental. It was market psychology at work.

What RENPHO Actually Sells

RENPHO is an entrepreneurial Hong Kong–based consumer electronics company that built its reputation the unglamorous way: competent hardware, aggressive pricing, no delusions of grandeur. Their low-end smart scale is still their most important product—not because it’s exciting, but because it’s adequate for the vast preponderance of users.

It measures weight accurately.
It tracks trends consistently.
It doesn’t require a subscription.
It doesn’t pretend to know things it can’t know.

That’s enough for most people.

RENPHO’s move upmarket wasn’t ideological. It was opportunistic. Hume’s heavy promotion established a new price anchor, and RENPHO noticed that there was money to be skimmed from customers who wanted something that looked more serious. So they dressed up their product line, added sensors, and priced accordingly—without abandoning the cheap scale that made their name.

This is segmentation, not self-deception.

What Hume Actually Sells

Hume, by contrast, is not really in the scale business. The hardware is just the entry ticket.

Hume sells a system.

The scale exists to create commitment. At $360 (or “$360, today only $195”), it feels like an investment. And investments demand protection. That’s where the subscription comes in.

Hume’s paid tier—roughly $10 a month or about $70 a year—does not unlock hidden sensors or improve measurement accuracy. It unlocks interpretation:

• Personalized insights
• Weekly reports
• Habit coaching
• Narrative explanations of your data

Cancel the subscription and the scale still works. You still get weight and basic metrics. What disappears is the commentary—the reassuring voice that explains what it all means and nudges you to stay engaged.

This is not technical lock-in. The device isn’t crippled. There’s no need to call Louis Rossmann and start sharpening pitchforks.

It’s something subtler: psychological lock-in.

The Sunk-Cost Trap

Hume’s model depends on pricing the hardware high enough that canceling the subscription feels irrational. Once you’ve spent hundreds on the scale, the monthly fee stops feeling like an expense and starts feeling like insurance against regret. “I already spent this much—why wouldn’t I get the full benefit?”

That’s the trick.

The subscription isn’t required for functionality. It’s required to maintain the story you were sold: that you didn’t just buy a scale, you bought into a disciplined, intelligent, data-driven system. Canceling doesn’t break the device—it breaks the narrative.

This is why the model works, and why it’s so effective with upwardly mobile professionals who are conditioned to “optimize” everything.

Tools vs. Systems

This is the real divide.

RENPHO sells tools.
Hume sells membership.

A tool does its job whether you believe in it or not. A system requires ongoing participation. If the results disappoint, the system never fails—you just need to engage more deeply, read more insights, stay subscribed.

That’s also why this reminds me of my refusal to pay for Garmin+. My watch already measures what it measures. I don’t need a monthly subscription to have the data summarized back to me in softer language.

Likewise, I don’t need a scale to explain my metabolism to me.

The Bottom Line

Hume’s real achievement wasn’t technological. It was psychological. They successfully reframed a commodity device as a lifestyle system and priced it accordingly. RENPHO noticed the opportunity and picked up a few crumbs with a premium offering of its own—without pretending the crumbs were nourishment.

For most people, the inexpensive Renpho remains not just adequate, but optimal. It measures the one thing that actually matters, tracks trends reliably, and doesn’t demand belief, loyalty, or a monthly fee.

The $200–$360 smart scale is the Corolla with the Bentley grille. If you enjoy the aesthetics or the esoterica, fine. Just don’t confuse decorative telemetry with truth.

Physics doesn’t need a subscription.
And neither does common sense.

Peptide Purgatory chronicles one man’s ongoing experiment with GLP-1s, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia while reading policy papers. So, ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: Scale Wars appeared first on The Nittany Turkey.

Do Your Eyes Feel Left Out? Feed Them GLP-1s, Too!

Welcome to Peptide Purgatory, which began as a chronicle of my experience dealing with Mounjaro and has expanded to encompass news and opinions about GLP-1 receptor agonist drugs. These drugs, such as Mounjaro, Ozempic, Victoza, Wegovy, and Zepbound, originally used for treatment of Type 2 diabetes, exploded wildly when researchers confirmed their weight loss effects. Since then, they have become the vogue treatment, replacing diet, exercise, bariatric surgery, and common sense.

You’ll get no sugar-coating here. If you’re fat, change your lifestyle and make a serious commitment to exercise before you turn to last resort medications whose downsides are not yet well understood. Insufficient time has transpired for meaningful longitudinal studies to reveal potential dangers. People blindly accept the largely unknown risks to hop on the “easy weight loss” bandwagon. However, one very serious evidence-based side-effect is loss of muscle mass, along with the rapid weight loss. So, we stress the necessity of strength-building exercise here for anyone taking GLP-1s.

How many will pay heed? Precious few, as these drugs are being pushed at people purporting to be a magical cure for obesity. Big Pharma wants to put more drugs in more people and keep them on their expensive pharmacotherapy for life. So, why emphasize that hard work will be involved? We don’t condone that attitude here. Those who take GLP-1s for weight loss need to work even harder than those who don’t to preserve their musculature.

That having been said, we transition into this week’s latest mishigoss. Seems like each week, a new specialty gets to benefit from GLP-1s. Big Pharma’s research engines are chugging like the Chattanooga Choo-Choo finding new and exciting uses for the incretin drugs. Every time I open up Healio or Epocrates, I expect to see some novel and unexpected use for GLP-1s. Big Pharma will have us all on these things sooner or later!

Ocular Claims and Ocular Oopses — Or Why GLP-1s Need a Second Opinion From an Ophthalmologist, Not a Dermatologist

If dermatology and rheumatology were jostling to join the GLP-1 party last issue, ophthalmology just waltzed in with a champagne bottle and no idea what it’s doing. A JAMA Ophthalmology cohort study this week claims that GLP-1 receptor agonists like semaglutide and liraglutide are associated with a dramatically reduced incidence of early (non-exudative) age-related macular degeneration compared with older weight-loss drugs — relative risks plummeting to the high-single-digit range over 10 years. Sounds like GLP-1s are about to take up golf and macular health on the side.

Before we start handing out ophthalmoscopes at endocrinology conferences, however, let’s be clear about the other ocular headlines piling up in the wake of this incretin stampede.

Not All Good News

First, not all the eye news is glow-up stories. There’s a growing body of pharmacovigilance and observational data linking GLP-1 RAs to rare but serious optic nerve events, most notably non-arteritic anterior ischemic optic neuropathy (NAION) — the “eye stroke” that can cause sudden, irreversible vision loss. Multiple cohort analyses and case reports suggest semaglutide and similar agents may be associated with increased NAION risk, albeit at low absolute incidence.

Regulatory bodies aren’t ignoring this; the European Medicines Agency’s safety committee has flagged NAION as a very rare but plausible side effect of semaglutide-containing drugs based on post-marketing surveillance. Ophthalmic associations caution clinicians to monitor vision changes specifically because NAION can manifest without pain and lead to permanent loss.

Other reported ocular signals include visual impairment, blurred vision, and retinal adverse event reports in pharmacovigilance databases, though causality isn’t established and risks vary across studies.

Inflammatory Eye Disease Benefits

What about inflammatory eye disease? Interestingly, large cohort data suggest GLP-1 users may have a lower risk of developing non-infectious uveitis compared with controls, perhaps reflecting anti-inflammatory effects — but this protective association isn’t uniform versus all comparators (e.g., SGLT2 inhibitors).

In other words: the eye story isn’t a one-way upward slope of benefit claims. There are plausible anti-inflammatory signals in uveitis risk, strong associations for reduced early AMD incidence, and contrary signals for serious optic nerve events like NAION — all in the same broad therapeutic class. It’s the kind of conflicting pattern that screams “we need randomized trials here,” rather than more retrospective spa-day anecdotes.

Get Your GLP-1s!

So if dermatologists look at GLP-1s and think “inflammation? treat it,” and rheumatologists nod along, and now ophthalmologists start touting lower early AMD risk, let’s not forget that some of their patients may wake up to find that semaglutide didn’t just shrink their adipose — it also squeezed blood flow to the optic nerve. That’s the kind of outcome no amount of metabolic nirvana can justify without solid prospective evidence.

Back to My Personal Week Off Mounjaro

Returning to my own decidedly non-observational medical adventure, while GLP-1s are being debated for their effects on retinas, optic nerves, skin, joints, and possibly begonias, I am living with something far more concrete: three fresh abdominal ports and a surgeon who has declared, with all the authority of Mount Sinai, that I am limited to ten pounds of lifting for eight weeks.

Ten. Pounds.

To comply, I have acquired what can only be described as pussy dumbbells — five pounds each, tastefully blue (not pink; I retain some dignity). With these, I may perform seated, high-rep Arnold presses, curls, and wrist curls, provided I do so without engaging my core, my ego, or my sense of purpose. Squats, deadlifts, and bench presses — the holy trinity — are forbidden. The core, apparently, is to be treated like a high-value optic nerve: observe only, no stress, no heroics.

Here I Sit, Broken Hearted

So here I sit on Saturday — traditionally a big lifting day — marooned with my little blue fucking dumbbells and a grip strengthener. No barbell. The bench is folded up by the chimney with care. No plates clanking. Normal breathing, no Valsalva. Just me, my ports, and a faint existential hum as I do 25-rep sets like a retiree in cardiac rehab.

This, it turns out, is the dark side of modern medicine. Drugs get marketed as lifestyle upgrades, robots punch precise holes in your abdomen, and when it’s all over you’re told that discipline now means restraint, not effort. I’m not injured enough to quit. I’m not healthy enough to train. I am, in lifting terms, a lost puppy — housebroken, well-intentioned, and deeply confused about why the leash is so short.

If GLP-1s really are good for whatever ails you, perhaps someone should study their effect on postoperative lifter despair. Until then, I’ll be over here curling five pounds and pretending it counts. So, I thought I would sum up the situation with a sarcastically contrived exercise program my surgeon can live with, even if I can’t.

Approved Exercises Under the DaVinci Xi Post-Op Protocol

(As interpreted by a confused patient with three abdominal ports, a surgeon with a stopwatch, and a lifelong barbell habit)

Tier 1: Explicitly Allowed (Because They Cannot Possibly Hurt Anything Important)

• Seated Arnold Presses (5 lb, Blue Edition)
  Performed while sitting upright like a Victorian schoolboy. Core engagement strictly prohibited. Facial expressions of effort discouraged.
• Seated Dumbbell Curls
  High reps encouraged, preferably to the point of philosophical reflection. Supination allowed; straining forbidden.
• Seated Wrist Curls / Reverse Wrist Curls
  Acceptable because no surgeon has ever cared about forearms. Bonus points for developing a Popeye-like imbalance no one asked for.
• Grip Strengthener
  Approved under the legal fiction that squeezing rubber does not transmit force to the abdomen. Also doubles as a stress toy.

Tier 2: Implicitly Allowed (But Don’t Make It Weird)

• Walking
  Yes, walking. Preferably at a pace suggesting “active recovery,” not “mall stroller.” Hills allowed only if approached emotionally flat.
• Breathing
  Encouraged. Deep diaphragmatic breathing permitted provided it does not look suspiciously like bracing.
• Standing Up From a Chair
  Allowed once per attempt. Repeated reps risk reclassification as squats and will be met with surgical disapproval.

Tier 3: Strictly Forbidden (The Surgeon’s “Absolutely Not” List)

• Squats
  Even imagining squats may activate the core. Do not visualize barbells.
• Deadlifts
  Known to awaken dormant abdominal demons. Banned outright.
• Bench Press
  “But I’m lying down” is not a defense.
• Planks, Crunches, Sit-Ups, Pallof Presses, or ‘Just a Little Bracing’
  Core engagement of any kind is considered a hostile act.
• Anything Described as ‘Functional’
  If it sounds useful, it’s probably illegal.

Tier 4: Grey-Area Activities (Proceed Only If You Enjoy Living Dangerously)

• Putting Groceries on the Counter
  Light items only. Milk jugs are contraband.
• Opening a Stubborn Jar
  Allowed if you pretend it opened easily.
• Laughing Hard, Sneezing, or Coughing
  Not technically exercises, but they absolutely feel like them right now.

Tier 5: Psychological Conditioning (Unavoidable)

• Staring at the Barbell Rack
  Permitted for up to 30 seconds. Longer durations risk acute melancholy leading to schizophrenic dissociation.
• Reorganizing Plates You Are Not Allowed to Lift
  A recognized coping mechanism, but only if done mentally — otherwise, verboten!
• Explaining to Other Lifters Why You’re Using Five-Pound Dumbbells
  Optional. Often exhausting. But at least they’re not pink.

Tier 6: Explicitly Not Counted as Exercise (But Will Still Happen)

• Googling “How Long Until I Can Deadlift After Hernia Repair”
  Repeated hourly.
• Mentally Redesigning Your Training Program for Week 9
  Futile but therapeutic.

Clinical Summary

Under the DaVinci Xi Protocol, strength training has been temporarily redefined as patience with light resistance, and discipline now means not doing the thing you’re best at. Compliance is measured not in PRs, but in not ending up back on the operating table.

Eight weeks feels long. It isn’t. But today?

Today you lift blue dumbbells and your own irritation.

ADVENTHEALTH POST-OPERATIVE DISCHARGE INSTRUCTIONS

DaVinci Xi–Assisted Abdominal Port Placement (a.k.a. “We Drilled Three Holes in You”)

Patient: [Redacted for HIPAA and Dignity]Procedure Date: Recent enough to still sting
Discharging Service: General Surgery (Robotics Division)
Condition on Discharge: Stable, ambulatory, emotionally inconvenienced

ACTIVITY RESTRICTIONS

For the next 8 weeks, the patient is advised to adhere to the following:

• Do not lift more than 10 pounds.
  This includes but is not limited to:
  • Barbells
  • Dumbbells larger than “embarrassing”
  • Egos
  • Hope
• No squats, deadlifts, bench presses, or movements that could be described as “real training.”
  Yes, we know what these are. No, we are not negotiating.
• Avoid core engagement.
  If you feel your abdomen doing anything at all, stop immediately and reconsider your life choices.

APPROVED EXERCISES

The following activities are permitted and medically sanctioned:

• Seated upper-extremity resistance training using 5-lb dumbbells
  (Color irrelevant. Emotional response expected.)
• High-repetition curls, Arnold presses, wrist curls
  Sets may extend into the “why am I even here” range.
• Grip strengthening devices
  Squeezing rubber is not considered a threat to surgical repair integrity.
• Walking
  Pace should suggest “responsible adult,” not “mall walker” or “Olympic hopeful.”

PROHIBITED ACTIVITIES

The patient should NOT engage in:

• Squatting “just to see how it feels”
• Deadlifting “light”
• Bench pressing “carefully”
• Planks, crunches, sit-ups, Pallof presses, or “accidental bracing”
• Any exercise described as:
  • Functional
  • Athletic
  • Compound
  • Satisfying

PAIN MANAGEMENT

• Mild discomfort, pulling, and the sensation of having been professionally punctured is expected.
• Laughing, coughing, and sneezing may briefly feel like a personal betrayal.
• Pain that worsens with lifting things you were explicitly told not to lift is not considered a complication.

WOUND CARE

• Keep incisions clean and dry.
• Do not poke, prod, or “check the integrity” with your fingers.
• Staring at them in the mirror is allowed but discouraged after the third time.
• Showing them off to uninterested visitors may enhance desired solitude.

PSYCHOLOGICAL CONSIDERATIONS

During recovery, patients may experience:

• Irritability
• Existential dread
• Sudden interest in grip strength metrics
• Repeated Googling of “when can I lift again”
• Acute jealousy of strangers deadlifting in public

These symptoms are normal and typically resolve when barbells are reintroduced.

FOLLOW-UP

• Resume normal training only when cleared by the surgeon, not when “it feels fine.”
• Eight weeks is temporary. Re-injury is forever.

FINAL NOTE FROM YOUR SURGICAL TEAM

You were fixed, not fragile.
Patience is the prescription.
Stupidity is the contraindication.

Peptide Purgatory chronicles one man’s ongoing experiment with GLP-1s, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia while reading policy papers. So, ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: Eyes Right! appeared first on The Nittany Turkey.

I. Apparently Knowing Your Own Anatomy Is Suspicious Behavior

My hernia repair adventure began innocently enough with the usual pre-op catechism: “Can you tell me your name and date of birth?” “Any allergies?” “What procedure are you here for today, in your own words?” I responded, perhaps too intelligently. Then came the question — whispered with the same tentative caution you use when approaching a feral animal:

“Are you a healthcare professional?”

The prep nurse asked it first.
Then the anesthesiologist asked it.
The nurse, still in the room, chirped, “I asked him that, too!” like she had discovered a rare specimen.

My first answer was polite: “No, just a retired engineer who reads.”
By the time the anesthesiologist repeated the question, I’d had enough:

“No. I just have a BRAIN. Why is it surprising that a patient might research his own surgery? Are most of your patients idiots, or what?”

To his credit, he admitted that most patients don’t understand their own bodies and that it was “refreshing” to meet one who did. It did not escape me that this confession merely confirmed my point.

Throughout the day, every interaction involving anatomical terminology triggered the same wide-eyed reaction. Medicine claims to value patient education, but the moment a patient demonstrates actual literacy, the room tenses like someone has violated an unwritten rule.

Meanwhile, this same system is perfectly comfortable with dermatologists and rheumatologists prescribing incretin-based metabolic drugs because someone saw an inflammation pathway diagram at a conference.

But I’m the suspicious one because I know what a peritoneum is. Anyway, I’ll briefly fill you in regarding my hernia repair somewhere in the prose below before we get to Bullshit Corner.

II. GLP-1s: Now in Dermatology, Rheumatology, and Possibly Botany

Healio’s latest entry in the GLP-1 hype archive spotlighted the “emerging role of GLP-1s in inflammatory diseases.” Dermatology and rheumatology now want their turn at the trough. At these growth rates, I fully expect a USDA announcement any day now:

“Preliminary observational data suggest semaglutide may reduce rust blight in soybeans.”

In a panel discussion, Dr. Joel Gelfand interviewed Dr. Fatima Stanford and Dr. Philip Mease — both highly credentialed, highly enthusiastic, and highly ready to treat nearly anything involving inflammation with incretins.

Stanford noted that GLP-1 receptors are “located throughout the body,” which in pharmaceutical dialect translates to:

“We’ve found just enough plausible targets to justify prescribing this drug class for everything except drywall repair.”

Mease added that obesity drives inflammatory burden (true) and therefore GLP-1s may calm inflammatory diseases across dermatology and rheumatology.

Conveniently, a KFF poll now says 1 in 8 American adults is taking a GLP-1 drug for something — obesity, diabetes, or just influencer vibes.

This is no longer a trend. It’s a metabolic cultural takeover.

III. The Inflammation Panacea Delusion

Let us pause and be serious for a moment — a brief, rare interval in Peptide Purgatory.

Yes, GLP-1s reduce inflammation.
Yes, adipose tissue is an inflammatory organ.
Yes, psoriasis and rheumatoid arthritis behave better when metabolic chaos is reduced.

But the leap from “mechanistically plausible” to “clinically standard” is where science ends and fashion begins.

Right now, GLP-1s are being treated like the duct tape of medicine: if it’s broken, wrap an incretin around it. Dermatologists prescribing pancreatic hormone analogues is the 2025 equivalent of surgeons using cocaine in the 1890s — enthusiastic, experimental, and not entirely thought through.

This is not evidence-based comprehensive care. It’s specialty-level improvisation wearing a white coat.

IV. Cancer Panic Update: Good News! GLP-1s Do Not Cause Cancer, and Bad News: They Don’t Cure It Either

Healio also summarized a major new meta-analysis of 94,245 participants across 48 randomized trials, concluding that GLP-1s:

• Do not increase obesity-related cancer risk, and
• Do not reduce cancer risk, despite the zealots who insist semaglutide has supernatural properties.

Thyroid, pancreatic, breast, kidney, colorectal, ovarian, liver, endometrial — no significant difference in incidence between GLP-1 and placebo arms during the median 70-week follow-up period.

This is objectively good news. After years of whisper networks about pancreatic cancer, C-cell tumors, or Ozempic turning your mitochondria rogue, the message is:

“These drugs do not appear to cause cancer. Please calm down.”

Of course, RCT follow-up is still short, so no sane person should declare GLP-1s definitively safe (or harmful) for long-term cancer outcomes. Five-plus years of data will be required.

Pharma executives, however, are already out celebrating.

V. Meanwhile, My Hernia Repair Was Performed by Someone Who Actually Knows What He’s Doing

While GLP-1s continue their march into every specialty with a pulse, my own interaction with medicine this week involved real, tangible competence: a robotic mesh repair of a right indirect inguinal hernia.

Not only did the surgeon repair the hernia, he also cleaned up four decades’ worth of adhesions from my 1984 open cholecystectomy. Every step of the procedure was done with the finesse of someone who actually cares where the mesh ends up.

When medicine is practiced with precision, it still works.
Which is almost quaint in 2025.

VII. Personal Update

For those following along at home:

• Post-op Day 1 pain: 0–3 depending on position and activity
• Post-op Day 2 pain: 2-5 depending on position and activity (but getting better later in the day)
• Fasting glucose: 103 mg/dL
• Weight: 81.2 kg (this is up significantly perhaps due to IV fluids and retention.
• Medications:
  • Metformin only for now
  • Farxiga resumes when hydration and intake normalize (then, I’ll be peeing out my donuts again)
  • Mounjaro restarts after full bowel function returns (i.e., the post-operative event heralded by trumpets and fanfare)
• Exercise: Sadly, no significant weight-lifting. I got myself a pair of pussy dumbbells so I would have something to sling around that met the surgeon-mandated qualification of “not greater than 10 lbs, which meant 2×5 lb. (they’re blue, not pink). I did my motility walk today, just 1.6 miles at a leisurely 20 minute per mile pace, which I tolerated well, except for our security guys asking me a few times, “Did you see a dog?” I’ll give you a dog, already—in the head, I’ll give you.

My mesh is in place, my glucose is civilized, and my body continues its stubborn refusal to behave like a 79-year-old.

Peptide Purgatory continues, as always — where GLP-1s expand into dermatology, cancer refuses to cooperate with hype cycles, and the greatest threat to healthcare remains the patient who walks in with a functioning brain.

Peptide Purgatory chronicles one man’s ongoing experiment with GLP-1s, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia while reading policy papers. So, ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: What’s next for GLP-1s? appeared first on The Nittany Turkey.

Pinstripe Bowl:

Penn State (6-6, 3-6 Big Ten) will face Clemson (7-5, 4-4 ACC) in the Bad Boy Mower Pinstripe Bowl at Yankee Stadium in da Bronx on December 27. More comments on this Bad Boy right here as December progresses.

Indiana Wins Big 10:

Congratulations to the Hoosiers, who hung on to beat Ohio State 13-10. I bet that Buckeye kicker is still thumbing a ride on I-80.

Notre Dame Snubbed by CFP:

So, they are now pouting, declaring that they’re not going to any bowls at all this year. They’ll take their ball and go home, while declaring the CFP rankings as “a joke”.

Franklin Hires Pry:

Not long after long-time James Franklin associate Brent Pry was fired by Virginia Tech as head coach, his successor in that position, James Franklin himself, hired Pry as defensive coordinator. LMAO

Final Rankings are In:

And Penn State isn’t.

The post Bad Boy Mower Bowl? appeared first on The Nittany Turkey.

GLP-1s for Teens: Because What Could Possibly Go Wrong?

If you’ve been wondering where all the Wegovy is going, here’s a hint: the kids are alright… because they’re getting priority boarding at the GLP-1 gate.

At ObesityWeek, a presenter from Nemours Children’s Health bragged about a quality-improvement project that could just as well have been titled “How We Blew the Roof Off Our Semaglutide Consumption.” After partnering their adolescent obesity clinic with a specialty pharmacy, they watched prescription volume rocket up a modest 1,680% in just one year. Yes, you read that correctly—sixteen-hundred percent. If Tesla’s stock chart did that, CNBC would have a stroke.

And the clinic didn’t stop at merely prescribing more drugs. Oh no. They built an entire logistical apparatus around feeding the GLP-1 machine:

• Weekly supply updates (because the supply chain is our new mood ring)
• Smart-phrase scripts to grease the skids
• Dedicated workflows for prior auths
• Auto-reminders to clinicians to re-up scripts before they run out
• A custom brochure so parents aren’t left wondering why their teen is suddenly on a $1,400 injectable

By 2024, the number of adolescents funneled into the specialty pharmacy increased by 1,057%. That is not a typo. That’s customer-acquisition growth that would make a Silicon Valley VC weep with joy.

And yes, adherence was—shockingly!—95.5%, which is what happens when a pharmacy holds your hand like an overcaffeinated concierge and your clinician calls you a week before you run out to make sure you don’t miss a jab.

But here’s where the confetti stops falling.

Nguyen ends with the understatement of the century:

“Increasing the use of GLP-1 receptor agonists in our clinic has created more work for providers and requires additional staff.”

You don’t say.

We’ve essentially built a pediatric GLP-1 industrial complex—one that needs ever more administrative workers to approve, dispense, monitor, and massage the process. The drugs are good tools, no argument there, but a system that must scale by 1,680% per year is not a system in control. It’s a system surfing a cultural and economic wave straight into the rocks.

And did I mention the presenter consults for Novo Nordisk? Purely coincidence, I’m sure.

If this is the future of adolescent obesity care—high-touch specialty pharmacy pipelines optimized for throughput rather than metabolic reasoning—then buckle up. We’re not treating a disease; we’re industrializing a demand curve.

But the lucky kids can have their cake and eat it, too, and spend 12 hours a day on their PlayStation for healthful recreation. A lithe body is just a jab away!

But if you think pushing the pricey drugs on teens is ridiculous, just read on. Cats are next! You’re not going to believe what follows, I promise. Although we are satirizing it here in Bullshit Corner, it was originally reported by ABC News, so it must be at least partially factual, maybe. Stay tuned as we see how the GLP-1 marketing geniuses are now expanding their fat-loss promising reach to corpulent felines.

Peptide Purgatory chronicles one man’s ongoing experiment with Mounjaro, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia while reading policy papers. So, ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: Fat Kids and Fat Cats appeared first on The Nittany Turkey.

In which Ohio State gets a freshman wideout, Penn State gets a new head coach, and everyone keeps pretending this is “education.”

Two Wall Street Journal pieces this week—one chronicling the Big Ten’s transformation into a billion-dollar content mill, the other tracing a brilliant teenager’s descent through the black-market underworld of high-school football—tell the whole story of modern college athletics far better than anything the NCAA will ever admit.

Together, they also explain the world into which Pat Kraft just dropped Matt Campbell, now officially Penn State’s head coach on an eight-year agreement pending Board of Trustees approval. And unless the trustees accidentally vote on last month’s dining contract instead of the coaching contract, that approval will be a parade float.

Kraft needed this hire to land squarely after the disastrous Franklin exit and the hapless rumor mill. But Kraft needs something else even more:

A miracle.

Because he’s not just hiring a football coach. He’s propping up the Penn State division of the Big Ten’s corporate money machine while simultaneously managing a $700 million Beaver Stadium expansion, a bottomless NIL arms race, a hyperactive transfer portal, an increasingly deranged fan base, and a conference whose only historical principle is now: “Can this bring in more revenue?”

Let’s not mince words: The AD job at Penn State in 2025 would break most Fortune 500 CEOs. Those guys have shareholders who at least pretend to understand risk. Kraft has message-board economists and donors who think “alignment” is something visible on an MRI.

And into that maelstrom steps Matt Campbell.

Scene 1: The Big Ten—From Tweed-Coated Morality Play to Private-Equity Fling

For over a century, the Big Ten prided itself on lofty ideals:

• “Academics first.”
• “Student-athletes.”
• Sneering condescension about the SEC.
• Professors blocking Ohio State from a Rose Bowl because a coach gave out improper benefits.
• No alcohol ads on the Big Ten Network, lest the children be corrupted.

Cue the laugh track.

Because now:

• The Big Ten is 18 schools deep, stretching from the Atlantic to the Pacific.
• It generates over $1 billion annually in media money.
• It seriously considered a $2.4 billion private-equity deal, which Michigan’s board correctly called “a payday loan.”
• It is spearheading a plan to expand the playoff to 24 teams, because 12 isn’t nearly enough chances to sprain hamstrings for television dollars.
• And the conference is playing Friday-night games it once declared heretical.

This isn’t evolution.
This is monetization cosplay.

The Big Ten long claimed to be the adult in the room while other conferences “sold out.”
Then it checked its bank statement, saw the SEC pulling away, and sprinted face-first into capitalism with all the subtlety of a rhinoceros on meth. Big Ten Commissioner Jim Delany, who served from 1989 to 2020, was the expansion mastermind; getting Penn State voted in back in 1990 was just the beginning. Last year, four West Coast schools joined what was originally a Midwest academic alliance. The Big Ten is now composed of eighteen football factories.

And yet administrators still give quotes about protecting “academic missions.” Sure. And Domino’s is protecting the ancient craft of breadmaking.

Scene 2: The Basement of the System—Where the Product Is Manufactured

Now enter Phillip Bell III, a kid who represents the true cost of the Big Ten’s revenue empire.

Bell is now a freshman wide receiver at Ohio State. But before that, he was:

• A national top-10 high-school prospect,
• A walking NIL lottery ticket,
• And—this is the important part—the financial plan for the adults around him.

His mother, drowning in debt and addiction, began moving him from school to school across California, shopping him like a condo listing. Bagmen and “street agents” offered five-figure packages, rent-free mansions, stipends, allowances, whatever it took.

He played 7-on-7 for a team backed by venture capital.
They flew private.
They marketed teens like IPOs.
Rules? Suggestions.
Amateurism? A charming museum artifact.

Meanwhile:

• Bell’s grades cratered.
• His family fractured under the financial strain and manipulation.
• His mother died at 39 after a cocaine-laced diabetic spiral in a Vegas hotel.
• His father and grandparents were cut out of his life.
• And at 18, he arrived in Columbus with a “caretaker” and no connection to his family outside a tragic obituary.

This isn’t a failure of the system.
This is the system.

Bell is the raw material.
Ohio State is the factory.
The Big Ten is the retailer.
Fox, NBC, and CBS are the wholesale distributors.

And the only part of the process anyone pretends is voluntary is the part where the kid signs his name.

Scene 3: The Pipeline Meets Happy Valley

Now look again at Matt Campbell’s job description and tell me this isn’t the same machinery—just at a different stage of production.

Campbell didn’t accept a college coaching job.
He accepted:

• A CEO role inside a billion-dollar corporate subsidiary,
• With no labor stability,
• No roster guarantees,
• No regulatory clarity,
• No budget ceiling,
• And 107,000 highly emotional performance reviewers screaming from the stands.

And Pat Kraft?
He’s the CFO, COO, and Chief Risk Officer of this circus.

The stadium project alone would give a NYSE-listed company’s CFO night sweats. Add in a coaching transition, a cutthroat conference, NIL inflation, portal volatility, egotistical donors, and a fan base that considers 10–2 a government-grade failure…

The Hot Seat

Kraft’s desk is essentially a legacy Pittsburgh blast furnace with a swivel chair attached.

Back in the Sandusky scandal days, hypocritical Penn State football fans decried the Freeh Report’s characterization of the “culture of football” observed at PSU. Despite those Sanguinarians wanting to sweep it under the rug, that corrupt culture is glaringly present. Along with the rest of the Big Ten, Penn State has sunk into the morass that was once known as college football and is now NFL Lite.

And here’s where the Bell story matters:
Campbell and Kraft must build, recruit, and retain a roster drawn from the same talent pipeline that produced Bell’s nightmare.

That pipeline is:

• Ungoverned,
• Cash-soaked,
• Exploitation-prone,
• Family-shredding,
• And now considered “normal.”

The Big Ten needs elite players.
Elite players come from environments like Bell’s.
Penn State needs to compete with Ohio State for those players.
Which means Penn State is, willingly or not, tied into the very system that destroys kids on the way up.

“Success With Honor” sounds noble until you realize half your recruiting pool spent high school being auctioned to the highest bidder at 7-on-7 tournaments sponsored by Amazon and Gatorade.

Scene 4: Leadership or Soul Selling? Pick One.

A former Ohio State AD said:

“There’s a narrow line between providing leadership and selling your soul.”

He’s wrong about one thing:
The line isn’t narrow anymore.
It’s a mile behind us, next to the Rose Bowl contract and the morality clause.

The Big Ten crossed that line when it chased broadcast markets instead of regional coherence.
It crossed it when it played Friday nights.
It crossed it when it considered private equity “modernization.”
It crossed it when money made all previous values obsolete.

Matt Campbell is inheriting that world.
Pat Kraft is expected to control it.
Phillip Bell is a casualty of it.

And the rest of us?
We keep buying tickets to the games and kidding ourselves that these are “students first.”

Final Scene: Welcome to the Show, Matt Campbell

Ohio State gets a blue-chip wideout.
The Big Ten gets another profitable season.
NIL collectives get deals to announce on social media.

Penn State gets a new head coach… who must:

• Win immediately,
• Rebuild a roster in the Wild West of NIL,
• Keep boosters at bay,
• Hit fundraising milestones for a $700 million stadium overhaul,
• And ensure the program doesn’t fall behind mega-programs operating on Silicon Valley economics.

All while Kraft tries to avoid becoming the next AD casualty of unrealistic expectations.

So yes—Matt Campbell is the new leader of Penn State football.
But don’t kid yourself.
He’s also the newest middle manager in the Big Ten’s industrial complex, where the stakes are higher, the timelines shorter, and the talent pipeline more warped than anybody wants to admit.

And somewhere in Sacramento, a father and two grandparents watch Ohio State games on TV and wonder when college football stopped being a game and started being an industry that consumes children.

The answer?
Right around the time the Big Ten figured out how to monetize everything except its conscience.

Epilog: Terry Smith Naivete

My recent posts here about the Penn State coaching search have provided comic relief at the expense of Facebook comment geniuses. At the same time, peering into that world has confirmed the naivete of the typical college football fan. Most ignore the sordid pecuniary crap I’ve ranted about above. They want to look at the Penn State coaching job as it might have been in 1959, when Rip Engle was coaching Richie Lucas.

Terry Smith would have fit in that model, but going 3-3 as interim head coach — with no financial worries on his shoulders and absolutely no expectations other than to play out the year — does not qualify him for the Football CEO job. Penn State needed someone who understood the realities of the position, and who conducted a program, albeit on a somewhat more penurious level.

I’m happy that Terry, who was exploring possible head coaching opportunities elsewhere, has decided to stay at Penn State. He will be a valuable asset in Matt Campbell’s organization, presumably coaching cornerbacks and aiding in recruiting.

I consider that a happy ending for Terry. I think elevating him to head coach would have likely consumed him and his family. Sometimes, one’s reach exceeds one’s grasp.

The post Straight Talk: Turkey Editorial appeared first on The Nittany Turkey.

Multiple national outlets report that Penn State and Iowa State’s Matt Campbell have agreed to broad terms and are in final negotiations to make him the next Nittany Lion head coach, pending formal approval.

I knew you’d ask what the geniuses on Facebook are saying, so here goes!

Facebook Reacts to the Matt Campbell Rumors: A Field Guide to Online Ornithology

If you ever wondered what it would look like if Noah opened the ark’s doors midway through a Category 5 hurricane, wonder no longer — because the Penn State fanbase has spoken, and boy, do they regret having the internet.

The Terry Smith Loyalists

These folks view Terry as the divinely anointed heir to JoePa, Moses, and possibly Beyoncé. The mere mention of Matt Campbell sends them into lamentations. Some claim this “slap in the face” means they’re switching to Ohio State — because nothing says “principled stand” like defecting to the Evildoers of Columbus. Others hope Terry grabs all the players and leaves in a glorious biblical Exodus. (Yes, someone actually invoked “Exodus” as if wide receivers will wander the desert for 40 years.)

The Doomsday Prophets

These are the people convinced the Campbell hire marks the official end of civilization. According to them, Penn State football is now:

• ruined,
• set back 20 years,
• doomed to “mediocracy” (their word, not mine),
• and on the verge of losing every recruit, player, donor, season-ticket holder, and possibly the Creamery’s patented Peachy Paterno recipe.

Several assure us they’re “done with the program,” which always lasts until the next 9–3 season.

The Franklin 2.0 Truthers

These fine scholars discovered via Infallible Google Search that Matt Campbell once shared oxygen with Nick Sirianni, which — in their minds — makes him James Franklin 2.0, 3.0, 4.0, and possibly the director’s cut. They cite Campbell’s record, Campbell’s failures, Campbell’s inability to beat Ohio State, Oregon, Michigan, Iowa, gravity, and time itself. At least one guy is still mad that Colorado beat Iowa State. In the same year. In a sport involving 22 players. Somehow this is Penn State’s fault.

The “Fire Kraft!” Crowd

A proud Penn State tradition: whatever goes wrong, fire the AD. Kraft is accused of botching the search, losing recruits, taking too long, taking the wrong amount of time, not landing a “big name,” and mishandling the sacred ritual of appeasing Facebook Comment Section Shamans. According to one gentleman, after this hire, the Board of Trustees can “shove his tickets” somewhere the sun doesn’t shine — a bold strategy for someone still planning to attend games.

The Culture-Police Gatekeepers

Several commenters gravely inform us that Matt Campbell is not a Penn State guy, which apparently disqualifies him from coaching football in State College. One declares another commenter “obviously ignorant of Penn State culture,” which is an unintentionally perfect summary of the comment thread itself.

The Optimists (Yes, They Exist)

A few brave souls venture that Campbell is… a good hire. Not great, but good. Or maybe excellent. Maybe even a “home run.” These people are immediately drowned out by everyone else screaming that we’ve made the worst decision since the linebackers let JJ McCarthy convert a 3rd-and-17.

The Conspiracy Theorists

These are the people who believe:

• Pat Kraft has secret tapes.
• Campbell is hiring Sandusky as defensive coordinator.
• Fake news is involved.
• This is all a plot.
  Of what variety? Doesn’t matter. They’re working on it.

The Stat Dump Guy

Every thread has one: the guy who, upon hearing rumors of a coaching hire, posts a JPEG of recruiting rankings as if he’s Adam Schefter crossed with a disgruntled actuary. This gentleman dutifully reminds us that Iowa State recruited like Iowa State. The world gasps.

The Pure Nihilists

These commenters simply type variations of:

• “UGH.”
• “Eew!”
• “Terrible terrible terrible terrible.”
• “No good!”
• “Awful.”
• “Smfh.”
  These are the haiku poets of Fan Rage.

The Straw That Broke the Camelback Guy

One fan declares he is “no longer a Penn State fan,” even though he was “born and raised 50 minutes down the road.” This is a classic Facebook departure vow — right up there with “I’m deleting this app,” followed by 900 more posts this week.

In Conclusion

The Facebook reaction to Matt Campbell is a glorious Rorschach test: people see whatever it takes to confirm that they, personally, hold the One True Opinion about Penn State football.

Whether Campbell wins big, flames out, or goes .500 forever, one thing is certain:

Penn State fans will still be yelling at each other on Facebook, and absolutely none of them will admit they were wrong.

The post This Could Be It: Matt Campbell to Penn State? appeared first on The Nittany Turkey.

While Penn State’s bumbling head-coach search committee continues to cling to false hopes — and somehow keeps driving what seem like worthwhile candidates to go running for the hills — our old pal James Franklin has been busy in Blacksburg charming the maroon-and-orange masses like he’s selling extended warranties on used Buicks.

Yes, while we anxiously await word from Pat Kraft’s Witness Protection Program for Athletic Directors, Virginia Tech fans are over on Facebook throwing rose petals, rice, and probably a couple of leftover turkey legs at Franklin’s feet.

Let us observe.

Act I: Hokie Honeymoon Hysteria

Some VT folks are already declaring Franklin a “class act,” an “excellent speaker,” and a man who “always says the right things.”

Well, yes. That’s the whole problem.

James Franklin always says the right things. The man could sweet-talk a malfunctioning Hamilton Beach blender into believing it’s a VitaMix.

One Hokie even claimed Franklin “gave his heart and soul” to Penn State.

I’d say he gave us a good, sturdy lease with an optional buy-out clause — but let’s not ruin their romance with reality. They’re smitten. Let them enjoy the glow before they learn about the fourth-quarter conservatism and the strange gravitational field that pulls every Franklin-coached team into the same November wormhole.

Act II: Penn Staters Crash the Facebook Reception

Naturally, PSU fans — aka “trolls” — arrived uninvited to the VT Facebook wedding banquet, bearing the gifts no one asked for:

• “2–23 in big games.”
• “Play-not-to-lose artist.”
• “Five-star QB hospice.”
• “You’ll love him… until you don’t.”

It was like watching bitter exes ambush a bridal shower. The Hokies didn’t know what hit them.

VT fans responded the only way new partners do in this situation:
“LOL you’re just jealous.”

Yes, sweetheart — we’re jealous. Jealous like someone who traded in a 12-year-old glitchy BMW for a reliable Honda and now watches the next owner brag about the heated seats that sometimes work.

But wait. Where the hell is the reliable Honda, Pat Kraft? Something about a Honda in the hand is worth two in the bush? Or two dozen? Coaching candidates, I mean. But I digress.

Act III: JoePa’s Ghost Enters the Chat

At one point a middle-aged Penn Stater unloaded a blistering sermon on the “young spoiled shits” of PSU fandom, scolding them for lacking “class” and claiming Paterno would be embarrassed.

Look, Paterno was embarrassed by a lot of things. But Facebook arguments? Please. Remember his reference to Twitter as “Tweedle Dum and Tweedle Dee”?

He’d shrug and go back to breaking down film on a 9-inch CRT.

Still, watching Penn Staters fight each other while fighting Hokies while we don’t even have a coach —it’s almost comforting in its dysfunction.

Act IV: The Hokies Learn the Language

As the thread grew, the Virginia Tech faithful began encountering the Franklinisms we know by heart:

• “Obviously, obviously, obviously…”
• “Same shit he said at PSU.”
• “Insert VA for PA for the next decade.”
• “He’ll recruit like Zeus and coach like your uncle who forgets the kids’ names at Thanksgiving.”

One Miami fan even showed up to explain things to everyone, because if there’s one program America looks to for guidance, it’s Miami.

Act V: When Reality Finally Peeks Through the Window

Sure, the Hokies are excited now.

Their recruiting class jumped from the low 100s to #22 in a day — which, to a program starving for relevance, probably feels like finding a twenty-dollar bill in an old winter coat.

But folks… we’ve seen this movie.
We bought the DVD.
We watched the director’s commentary.
We lived through the sequels.

Franklin gives you hope. He gives you hype. He gives you a recruiting bump.

And then November arrives and your blood pressure spikes to numbers that violate OSHA standards.

He’s the best coach in America at building the hot-air balloon.

He’s the worst coach in America at landing the damn thing.

Final Thought From a Turkey Sitting on the Fencepost

While Penn State fans wait for the coaching search committee, namely Pat Kraft, to emerge from whatever locked padded cell they’re currently in — presumably arguing whether to offer the job to Terry Smith, Prunella the Psychic Groundhog, or a Magic 8 Ball — at least we can take comfort watching this Facebook drama unfold.

Virginia Tech thinks they’ve found The One.

Bless their hearts.

From here in Happy Valley, we raise a toast:

Good luck, Hokies. The Franklin Experience is fun… until the warranty expires.

The post Peeping Through the Hokie Holes: Franklin’s First Week in Blacksburg appeared first on The Nittany Turkey.

I thought I would have a little fun and share it with all six of my readers. I fed a random Facebook thread about Pat Kraft and his progress (or lack of same) on the Penn State coaching search to ChatGPT and asked it to summarize it for me. Results follow.

Theme of the Thread:

Penn State fans have lost their collective minds, trust in Pat Kraft is near zero, and every coach from Manny Diaz to some fictional guy from a Canadian junior high is being proposed with deadly seriousness.

Main Takeaways

1. “HE’S NOT LEAVING!”
Half the commenters insist Sitake would never leave BYU, Houston, his grandkids, the grocery store he likes, etc. Basically, everyone is convinced nobody wants the PSU job.

2. “CALL EVERY COACH ON EARTH.”
People toss out names like they’re drafting a fantasy league:

• Manny Diaz (twice)
• Matt Campbell
• Bill O’Brien (LOL)
• Mike Tomlin (double LOL)
• Pete Carroll
• Joe Moorhead
• Some guy named Klein
• Even fictional movie coaches

3. THE TERRY SMITH RELIGIOUS WAR
There are two factions:

• Team Terry: “Just hire him already or the whole roster will hit the portal!”
• Team Anyone-But-Terry: “If you hire him, PSU becomes Purdue with worse uniforms.”

4. Overarching sentiment: Pat Kraft has the strategic clarity of a malfunctioning Roomba.
Repeated complaints:

• No plan
• No communication
• No recruiting
• No splash hire
• No direction
• No clue
  Several want him fired yesterday.

5. “PSU isn’t actually a top-tier job.”
A few realists say the quiet part out loud:
40 years without a natty ? You’re not Alabama, get over it.

6. Apocalypse talk.
Dire prophecies include:

• PSU becoming a “sacrificial lamb”
• The roster evaporating
• Recruits bolting
• The program collapsing
• Sandusky but make it administrative

7. General Vibes:

• Panic
• Despair
• Delusion
• Torches and pitchforks
• Weird GIFs
• Your standard Facebook football riot

Bottom Line

It’s a digital mob shouting contradictory nonsense:

• Everyone sucks
• Everyone should be hired
• Everyone is unavailable
• Kraft ruined everything
• Terry Smith will either save PSU or destroy it
• The coaching candidates range from former PSU assistants to fever-dream movie characters

In short: absolute peak Facebook expertise.

The post Penn State Coaching Search, December 3 appeared first on The Nittany Turkey.

When I read yesterday night’s news about the house fire in Sanford, Florida — a family’s home gutted, their EV incinerated, a teen daughter who barely escaped by jumping from a second-story window — I felt something old engineers feel: a cold, unavoidable anger. The fire started “at or around the … garage charging station,” investigators say.

I feel horrible for the family. While the investigation will reveal the exact cause of the fire, it is likely related to a faulty charger installation, not some freak battery malfunction you’d read about in sensational EV-fear articles. Unfortunately, an increasingly prevalent cause of many house fires involves home wiring, a charger, and someone’s DIY–or “cheap-handyman” wiring job.

If you own an EV (or think you will), and you let yourself be talked into saving a few bucks by handling the charger install yourself — or by hiring a jack-of-all-trades handyman or the kid down the street who “knows something about wire” — you’re rolling the dice. And right now? The house always wins.

The last place you want to go for advice — in just about any life situation — is social media. Despite assurances you see on Facebook or in YouTube DIY videos, EV charger installation is not as easy as stringing up the Christmas lights. A 60-amp, 240-volt circuit driving a continuous load for hours is serious business. A cut-rate or do-it-yourself job can save money momentarily, but could cost you big in the long run.

EVs Are Not the Enemy — Bad Wiring Is

First, let’s put a stake through a myth: EVs are not inherently statistical firebombs. Multiple analyses show EVs catch fire far less often than gasoline-powered cars.

That’s good. But it doesn’t mean EVs + home charging = no risk. A growing body of fire-safety data shows:

• Every year in the U.S., tens of thousands of residential fires stem from electrical distribution and wiring problems — not candles, not kitchen mishaps, but wiring, outlets, and electrical connections.
• As home charging becomes more common, merging high-power EV chargers with a home’s electrical infrastructure — sometimes decades old — creates a stress test a DIY install often fails.

In short: EVs may be safe — home installations aren’t automatically so.

“Outlet” Isn’t a Generic Plug — It’s a Critical Link

If you’re thinking, “It’s just plugging in … how hard can it be?” — think again. The “outlet” that powers your EV charger is not a light socket. It’s the weak link in a chain that, if built or maintained poorly, can ignite the whole damn house.

EV-Rated Receptacles Exist (Use Them!)

• The standard outlet many people use — a NEMA 14-50 or similar — was originally for stoves or RV pedestals, not continuous high-current loads for hours. Over time, those can degrade under repeated plug/unplug cycles.
• Recognizing this, manufacturers and the electrical-safety community now push proper “EV-rated” or “heavy-duty” receptacles / connectors designed for repeated high-current charging sessions with better contacts, improved tolerance for heat and wear, and more robust anchoring of conductors.

If you’re powering your EV via a plug-in (non-hardwired) unit — this matters. Don’t rely on the cheapest outlet you find at the hardware store, like the one pictured here.

Even the Good Ones Wear Out — Inspection & Maintenance Is Not Optional

EV-grade receptacles and plugs take punishment. Repeated plug/unplug cycles — plus hours of heavy current draw — weaken internal clamp contacts, degrade spring tension, and create tiny resistive spots that heat up. Over time (months to years), those spots can become arcing sources under load, especially if someone wiggled the plug, misaligned it, or forced a poor fit.

A properly installed charger does not guarantee forever safety. Instead — treat it like any critical home infrastructure: inspect and maintain.

A Reasonable Maintenance Checklist for Plug-in (or Outlet-fed) Chargers

If you have a plug-in EV charger — or plan to — print this, stick it in your glove box, or set a recurring reminder.

• Check plug fit. Plug should seat firmly; no looseness or wobbling. If the plug wiggles or feels sloppy: replace the receptacle.
• Thermal check during charge. After 10–15 minutes of charging, carefully feel (or infrared-scan) plug and outlet face. If it’s more than mildly warm (say, “hand hot”), that’s a red flag — unplug, stop using, call an electrician.
• Inspect for discoloration or deformation. If outlet plastic is discolored, melted, cracked, or the plug housing shows signs of heat or scorch marks — ditch it immediately.
• Check wiring and grounding. If you can view rear-terminal wiring (e.g. in accessible junction boxes), ensure conductors are intact, properly insulated, and ground/bonding conductors remain connected.
• Verify breaker rating matches load. The breaker feeding the outlet must match wire gauge and charger current. An undersized breaker or oversized load is a classic fire trigger.
• Do a full check-up annually — by a qualified electrician. Have them inspect torque on all connections, verify wiring gauge, test for hot spots or resistance anomalies, ensure grounding.

Treating the outlet like a critical safety system — not an afterthought — can make the difference between “EV-convenient” and homelessness.

The Only Responsible Way to Install — and Maintain — a Home EV Charger

If you’re installing — or replacing — a charger:

1. Hire a licensed electrician — not your nephew, not a cut-rate handyman, not someone “who’s handy with a screwdriver and watched a YouTube video.” Charging installations should meet code, load calculations, grounding, conduit/wire gauge, breaker sizing — the whole nine yards.
2. Use EV-rated receptacles or hard-wired EVSE per manufacturer instructions. Don’t cheap out. The upfront cost of a rugged outlet and proper installation is small compared to the cost of a burned home.
3. Pull permits and get inspection (if local regulations require). Many jurisdictions will require it — and it’s there for good reason. Permit + inspection means someone officially checked your work; that can make or break your homeowner’s insurance if something goes sideways.
4. Schedule maintenance. Note install date, equipment model, breaker/wire specs — then check the outlet annually (or every 6–12 months if used heavily).
5. Monitor usage conditions. If the charger’s plugged into a damp garage, near combustible storage — rethink it. Electrical fires don’t need much help once something goes wrong.

This Isn’t “Anti-EV” Fear-mongering — It’s Home-Electrical Reality

I’m not arguing EVs are evil. They aren’t. In fact: by many credible measures, EVs are less likely to catch fire than combustion-engine cars.

But here’s the stain-on-your-shirt truth: home charging — if done wrong — introduces risk. And when risk is overlooked, ignored, or cheaped out on, the results can be more brutal than a highway fender-bender.

If you care about safety — for your home, your family, your neighbors — treat EV charging like the heavy-duty electrical installation it is, not like a phone charger you plug in with half your fingers crossed. Because when a plug overheats or arcs, it doesn’t care if you meant well.

The post PSA: Don’t Cheap Out on EV Charger Installation appeared first on The Nittany Turkey.

Let’s start with the obvious: I know absolutely nothing about what Pat Kraft and the Old Main Brain Trust are doing. I don’t have clandestine access to Kraft’s burner phone, I’m not hiding in a ventilation duct above James Franklin’s old office, and I sure as hell don’t get my intel from the same YouTube “insiders” who think NIL is a cryptocurrency.

But at least I’m honest about not knowing a damn thing. That already puts me miles ahead of 90% of Facebook.

Speaking of which, the self-appointed sages of social media need to shut their festering pieholes for five minutes. Every basement-dwelling Nostradamus thinks they’ve cracked the Penn State coaching code because they once attended a Blue-White Game drunk. Their “insights” are so wildly incorrect that ChatGPT could be trained solely on their garbage and become dumber.

Take this Facebook guru who told me to “grow up” because I dared to question Saint Terry Smith’s coronation. Apparently, if you don’t accept his opinion as gospel, you’re the problem. The man wouldn’t even admit that he had an opinion — no, no, it was simply “the truth,” as revealed to him via divine revelation or possibly a cracked Magic 8-Ball.

You will find none of that unhinged, chest-thumping certainty here. Everything I write is my opinion — glorious, well-earned, meticulously sharpened opinion — and you’re welcome to call me out anytime. Unlike the Facebook prophets, I’m not afraid of nuance, debate, or reality.

Fans Don’t Know Shit (Film at 11)

I’ll say it plainly: fans don’t know jack-shit about coaching searches. Not current players, not former players, not the faculty, not the alumni, and especially not the drunk guy in Section WC who thinks Jimmy Sexton is the starting quarterback for Oregon.

None of these people have the faintest clue what’s actually happening behind the scenes, but boy do they love hearing themselves talk.

Fans want Terry Smith because he “feels right,” meaning he reminds them of a sepia-toned memory of the Paterno era when milk was 37 cents and nobody transferred unless they flunked an Econ midterm. They want Smith… but they also want a national title. Fans want continuity… but also a coaching overhaul. They want “success with honor”… in a modern NIL death-match where boosters are dumping more money on 18-year-olds than tech startups spend on burn rate.

Let Us Show You How to Run the Program, Because WE KNOW!

But sure, let’s give Terry “a two-year contract to see what he can do,” says the guy currently watching the tow-truck driver hooking up his repossessed 2009 Camaro on the fifth unpaid month of an 84-month loan.

Another social media intellectual claims Kraft is “hesitating because he knows fans want Terry.” Right. Pat Kraft — a man whose future employment actually hinges on this decision — is supposedly steering the ship based on the emotional whims of dudes who couldn’t manage a peewee flag football roster without getting into a fistfight with the snack parent.

Then, there’s the guy who drops a name — and nothing else.

“Urban Meyer”

I guess the purpose of those terse comments is so later on he can point to the one name he got right, after all the other misses dropped strategically elsewhere in the same comment stream, and say, “I told you so!”

“Lou Holtz”
“Lincoln Riley”
“Doc Rivers” — Oops, wrong sport! Sorry, my bad. Meant to drop that in the NBA thread. Does anyone know how to delete a comment????

Chesney to UCLA — Humanity Shocked to Discover We Know Nothing

Our supposed front-runner, Bob Chesney, is reportedly off to UCLA. So much for our clairvoyance here at Nittany Turkey HQ.

Now watch social media invent reasons why he didn’t pick Penn State:

• “PSU lowballed him.”
• “UCLA has beaches!”
• “He hates the color blue.”
• “Chip Kelly told him the secret of life.”

It’s all crap. Nobody knows anything. If you flip a coin over a dumpster fire, you’ll get better accuracy.

Enter Kalani Sitake, Maybe, Possibly, Perhaps, If the Moon Is Right — OR NOT!!!

Briefly emerging as the newest, hottest name in the coaching search fiasco is BYU head coach Kalani Sitake, who has allegedly been chatting with Pat Kraft for months… or for five minutes… or maybe he’s never even heard of Penn State and thinks we’re still in the Big Ten East.

Rumors had a private jet heading from Provo, Utah to State College last Saturday night. The Facebook Rumor-Monger-In-Charge posted a FlightAware flight plan as absolute proof beyond a shadow of a doubt that Sitake was being hired at the airport at 1:30 AM.

Being a cynic, I demand to see the flight plan for the bus from campus to the airport carrying the two dozen HR clerks necessary to make that happen, along with Dr. Neeli Bendapudi to swear him in on the tarmac, and the tattoo artist to emblazon the Nittany Lion logo on Sitake’s expansive ass cheek before he can climb the boarding stairs and hie himself back off to Provo.

Think that’s a bit fantastical? Well, Mateys, on Facebook, ridiculousness knows no bounds.

If that bus flight plan doesn’t exist, someone will post a fake one.

So, what the hell do we know?

What we do know is that Sitake:

• Is a Mormon.
• Is of Tongan heritage.
• And — shocking twist — can actually coach.

Naturally, this has triggered the Facebook Mensa chapter, which insists that “anyone can coach in the Big 12.” These are the same people who believe that offensive coordinators don’t matter, the forward pass is optional, and NIL is a deep-state conspiracy.

The only thing anyone can say for certain: Pat Kraft isn’t betting his job on someone who can’t coach. That’s just common sense — which explains why it’s absent from 99% of fan commentary.

Wait! There’s Breaking News!

HOT FLASH!!! Oops. Sitake is staying at BYU — at least that’s what the semi-skilled pundits are currently reporting. One more flash in the pan assaying as fool’s gold.

BYU apparently felt they had a good thing going on there, despite the Facebook critics saying the Big 12 is bullshit and Sitake can’t coach, and despite Kraft allegedly making him an offer he could not refuse, an offer juicy enough to pry a dedicated Mormon family man out of Mormon Central.

The “information” I came across suggests that although the BYU administration couldn’t cough up the scratch to compete with Penn State, the Church of Jesus Christ of Latter Day Saints and its vast army of parishioners went all out to retain their guy. Whether or not this is bullshit remains to be seen.

But what the hell — who on God’s green Earth, Mormon or otherwise, knows how serious a candidate for the Penn State job Sitake ever was?

So, never mind. Nothing to see here. Move right along.

Where Did All the Other Names Go?

Whatever happened to the trifecta of DeBoer, Daboll, and Da Bullshit?

Were they real candidates? Were they figments of Twitter’s collective fever dream? Did someone run their names through Madden, declare them “interested,” and call it a scoop?

Who the hell really knows?

One Facebook scholar confidently announced that “Penn State is only the 19th or 20th best job in college football.” Sure. And I’m the 19th or 20th best synchronized swimmer in Central Florida. Let’s all argue meaningless rankings based on absolutely nothing and declare victory because “everybody knows.”

What Have I Told You?

Absolutely nothing you didn’t already know.

But damn, it felt fantastic tearing into social media’s boundless stupidity. Sometimes the hot air has to escape, lest the pressure build up and I explode like a Rutgers punt returner.

And that — unlike everything on Facebook — is indisputably, delightfully true.

The post Boiling Over! appeared first on The Nittany Turkey.

Hello, Peptide Purgatory fans! Today’s issue was inspired by the WHO, who keep spouting that now all too familiar mantra: “Obesity is a chronic, relapsing disease requiring lifelong treatment.” I hit that subject hard before; however, as counterpoint to WHO’s Special Communication published today (December 1, 2025) in JAMA, I have a few more things to say. Opinions are a dime a dozen (or there’s that other characterization I won’t repeat in polite company), so draw your own conclusions. Normally, this kind of thing would find its way to Bullshit Corner (it already has done so), but I felt it was a worthy feature for this week’s issue.

After lambasting the WHO, I’ll give you an update on my forthcoming medical event: hernia repair surgery, coming up on December 9.

Opinion: Follow the Money, Not the Molecules

WHO’s GLP-1 Guideline: Equity Theater Meets Pharma Economics

The World Health Organization has finally dropped its long-gestating guideline on GLP-1 therapies, and—stop me if you’ve heard this tune before—it reads less like a clinical document and more like a global financing prospectus dressed in a lab coat.

Yes, of course WHO repeats its favorite talking point—obesity is a “chronic, relapsing disease requiring lifelong care.” They love that line. It’s the tent pole that holds up the circus. Without the “lifelong” part, there’s no justification for the pharmacological mortgage they’re proposing.

But here’s where things get interesting, and fortunately, new.
This time, it’s not about the biology. We’ve beaten that horse so thoroughly it’s donating its organs. This time, the game is financing.

The WHO Playbook, Page One: Declare It a Disease

Once you call obesity a chronic, relapsing illness, you open the door to chronic, relapsing payments. It’s elegant, in a dystopian way. Especially when you simultaneously add GLP-1s to the Essential Medicines List—a move that magically transforms $1,000/month injectables into something the world is now entitled to.

If insulin in sub-Saharan Africa is still hit-or-miss, imagine the logistical chess involved in delivering weekly refrigerated incretin cocktails to communities where electricity isn’t a full-time employee.

But don’t worry, WHO has a plan: You pay.

“Equitable Access” = Your Wallet, Their Need

WHO talks a big game about “equitable access,” “universal coverage,” and “tiered pricing.” To the untrained eye, this looks like compassionate global health policy.

To anyone who has ever read a balance sheet, it’s obvious what they mean: First World taxpayers underwrite GLP-1 access for the developing world while Big Pharma’s margins remain gloriously untouched.

They spell it out in bureaucratese:

• “financial coverage under national insurance schemes”
• “tiered pricing”
• “pooled procurement”
• “universal health coverage frameworks”

Translation: “Rich countries, please open your checkbooks, because we’re about to scale a class of drugs that most of your own citizens can’t afford.”

It’s global health Robin Hood, except the Sheriff of Nottingham (Novo/Lilly/Pfizer) keeps the purse.

The Real Problem: WHO’s Priorities Are Upside Down

Let’s be blunt:
Many countries still struggle to provide reliable access to

• insulin
• antihypertensives
• antibiotics
• clean drinking water

Yet WHO is now preparing a framework to deploy weekly GLP-1 injections as a global public good.

This is health-policy absurdism.
It’s the global-health equivalent of buying everyone a Peloton when you still can’t fix the potholes.

The Conclusion Nobody Asked For, But WHO Delivered

WHO keeps insisting “medication alone cannot solve the problem,” then spends twenty-two paragraphs laying out a global financial system for scaling medication.

At this point, the contradiction is so blatant you could bounce a basketball off it.

If this guideline represents the “new obesity ecosystem,” it looks suspiciously like the old one—except now it comes with a moral lecture about solidarity and an invoice addressed to taxpayers in countries that already can’t afford their own GLP-1 copays.

But hey—at least it’s “equitable.”

My Week on [no] Mounjaro

As you know if you’ve been following my boring trajectory, my numbers have been stable for quite a while, with BP < 120/70, HbA1c around 5.6%, and average glucose somewhere in the 105-110 range. Enough said there.

I promised that I would update you on the forthcoming hernia repair surgery, so if you’re squeamish, bored, or simply don’t care, stop reading.

The surgery on December 9 is to be performed laparascopically by the Da Vinci robot—UNLESS they have trouble getting past my old gall bladder surgery incision scar from 1984. In that case, it will be open surgery with a longer recovery time, which will piss me off.

The recovery time is already too long. I have an eight-week restriction that allows me to lift no more than 10 lbs. Every time I cough, sneeze, or laugh, I’ll get lightning-bolt jolts of pain. Sound like fun?

My Pre-Op Call

I got a call today from the very-Indian sounding OR nurse with a non-Indian name. She reviewed my prescription drugs, told me which ones I could continue taking and which I needed to stop. My primary care physician had already told me to discontinue Mounjaro and Farxiga two weeks prior to surgery, with which Hannah agreed. She also told me to discontinue all supplements from now until after the procedure.

She reviewed my prior surgeries and chronic illnesses, and then reviewed my bathing instructions for the night before and morning of surgery. I’ll need to take a Hibiclens shower, use freshly washed towels, and sleep in freshly washed linens. In the instructions Hannah sent me, I was directed to bring my CPAP machine, tubing, and mask, if I use such an apparatus at home. Well, I do, so I will, but I wonder how they’ll ensure it is free of contaminants.

She confirmed who would be taking me home after the procedure and that they would be staying with me for 24 hours. No Uber drivers or bus drivers are allowed to be that person, though, so my wife will suffice.

Butbutbut, When Is It, Already?

Then, she asked me if I had any questions. Yes, one BIG one: no one gave me a time for when to show up at the surgical unit. Little omission there. Well, it turns out that I’ll be contacted by the surgeon’s office THE DAY BEFORE surgery to give me that little tidbit. Oy, vey! Modern hospital scheduling! They’re worse than Spectrum or Terminix! Maybe they’ll give me a window between 12 and 4.

What do I fear the most? I worry about losing muscle mass, given the eight week no-lifting restriction. But I’ll be able to walk, climb stairs, drive, and do some stretching and body weight strengthening exercises. No doubt that I’ll need to take it easy for a couple of weeks, as 79-year-old bodies don’t recover from surgery like they did when they were 39.

Sendoff

So there you have it: another week in which the WHO sermonizes about “equity,” Big Pharma quietly measures your inseam for a permanent financial wedgie, and I prepare to let a robot rummage around my abdomen like it’s defusing a bomb.

If all goes according to plan, I’ll crank out next week’s issue before I’m reduced to a post-op blob in pajama pants, mumbling about lifting restrictions and the good old days when a man could sneeze without seeing God. If things get delayed, chalk it up not to sloth but to the fact that I’ll be temporarily sidelined by modern medicine—ironically the same circus I spend every week lampooning.

In the meantime, take care of yourselves, watch your step on the WHO/GLP-1 slip-and-slide, and pray that the da Vinci robot has a steadier hand than the folks scheduling my check-in time.

See you on the other side—preferably still in one piece and with most of my muscle mass intact.

Peptide Purgatory chronicles one man’s ongoing experiment with Mounjaro, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia while reading policy papers. So, ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: WHO are They Trying to Kid? appeared first on The Nittany Turkey.

One game. Two teams. Two competent offenses. Zero Defense.

Where were the defenses? No one knows. Especially not Jim Knowles, Penn State’s high-priced defensive coordinator mistake poached from Ohio State last off-season. Ryan Day is still smugly grinning over that one.

By the numbers: Penn State 509 yards, Rutgers 533 yards, combined 1,042 yards.

Oy, Such Good Offense, Becky!

Some amazing displays of offense by both the Scarlet Knights and the Nittany Lions provided sufficient entertainment to avert catatonia.

It was a field day for Rutgers’ Golden Greek senior QB Athan Kaliakmanis, who completed 16 of 22 passes for 338 yards and three touchdowns. His prime target, sophomore KJ Duff, caught five of those accurate zingers for 127 yards and a touchdown, while primo sophomore running back Antwan Raymond ran unabated for 189 yards and a touchdown on 29 carries.

The visitors were no slouches against the suspect Rutgers defense. Ethan Grunkemeyer completed 17 of 21 passes for 209 yards and a touchdown, including a 53-yard touchdown pitch-and-catch to emerging start tight end Andrew Rappleyea. The high-priced wide receivers were mostly absent. Meanwhile, the highly complex game plan engineered by Terry Smith, which centers around giving the ball to Kaytron Allen, closing your eyes, and hoping the offensive line gets out of his way worked well. Allen wound up with 226 yards on 22 catches and a touchdown, including a long run of 55 through the desolate, unpopulated wilderness of the Rutgers secondary. His roommate, Nick Singleton added 86 yards on 9 carries and two touchdowns with a long of 53.

Turnovers’ll Killya

In the end, it was the game’s only turnover, an uncharacteristic fumble by Kaliakmanis, producing a scoop and score for Amare Campbell with 7:27 left in the fourth quarter that tipped the game’s balance Penn State’s way. The Nittany Lion defense (or whatever that unit was) managed to stop the Scarlet Knights on their subsequent possession, and that was that.

I should note that, to the defense’s credit or lack of same, they were called twice for too many men on the field. Good try, guys! But they still couldn’t stop Rutgers with 13 men.

Rutgers Talent

This Turkey was impressed by the Rutgers young skill position players. If they had a defense and an offensive line, then they’d be something. But as it stands, their two sophomores, KJ Duff and Antwan Raymond are NFL material. They gonna play on Sunday, as da cliche goes, at da nex’ level. And given the bullshit of the transfer portal, both are liable to finish their “edumacation” at some other institution of higher football learning than the State University of New Joisey.

Rutgers could enter 2026 with an elite offensive core… or watch it evaporate in January, as is the modern way.

Bowl Eligibility: yay

Well, they get a cold-weather, mid-December destination and a lackluster opponent. We’ll know where they’re going after championship weekend (as if what happens in the top tier matters). The main thing they get is another 15 practices, so the guys who will be playing elsewhere next year can audition for their new squads.

The Sanguinarians’ fervent hope: a matchup with ACC laggard Pitt in the Pinstripe Bowl in da Bronx.

Boy, That Was Sure Fun!

Fans love offensive displays. Especially when it’s their boys putting on the show. When it’s both sides creating offensive fireworks, not so much.

Defensively, this game was pure sludge. Penn State’s tackling was atrocious, edge discipline was nonexistent, and the secondary played like they’d been told the ball was poisonous. They eventually sacked Kaliakmanis three times, but still…

Rutgers wasn’t much better. They gave up 509 yards and rarely looked like they had any idea how to slow Allen. Their DBs got caught flat-footed on the Rappleyea touchdown. Stop me if you’ve heard this before: neither team’s defense would rank in the top half of the MAC right now.

So, Yeah, We’re Back to the Coaching Cloud, Already

The Knowles Question and the Big Empty Chair

Penn State enters December with:

• a 6–6 record
• bowl eligibility, barely
• no permanent head coach
• and incidentally, a serious question about Jim Knowles’ future

Knowles was supposed to bring steel-spined, mechanically precise defense to State College. Instead, he oversaw a unit that surrendered:

• 533 yards
• 36 points
• and more explosive plays than a July 4 fireworks stand

And, yes, we’ll say it. THIS WAS FRIGGIN’ RUTGERS!

You don’t survive that in the middle of a coaching transition. Not without a rock-solid head coach backing you. And right now, Penn State doesn’t have anyone backing anyone.

The new HC — whomever that ends up being — will either:

1. Clean house entirely (most likely), or
2. Keep Knowles for continuity and recruiting (unlikely after this performance).

In other words, Knowles’ office should already have boxes in the corner.

Da Bottom Lion: A needed win that proved nothing

Penn State needed this win. They got it. They earned bowl eligibility.
But they also showed the entire country why the program is in transition:

• Elite running game? Yes.
• Functional passing game? Finally.
• Defense that could stop a sneeze? Absolutely not.

Rutgers, meanwhile, has talent — real talent — but faces the new college football question: Can you keep it?

And Penn State now stares at a coaching carousel that will determine whether this win leads to momentum… or is simply the last gasp before the rebuild.

Watch this space for further rumination about the coaching morass, the Toilet Bowl, and related subjects, as we enter the turmoil of commitment/recruiting/transfer time — the Wild West of NCAA semi-pro, NFL Lite pretend education football!

The post In Absentia appeared first on The Nittany Turkey.

And so, the Turkey is here with you trackside to handicap the Penn State Stakes, from the chalk to the longshots and everything in-between. If my coaching derby handicapping is anything like my horse racing handicapping was back in the day, you might want to avoid the $100 window.

Understand that I’m looking at this as an amalgamation of common sense and predicting the unpredictable — like what makes Pat Kraft tick. I obviously don’t know much about the latter, but I can cut through the emotional bullshit and instill a modicum of the former.

Feature Race of the Season

Race 10 — “Penn State Stakes,” $65,000,000 HcpS, (special weights), 1-1/2 mile on the Hype Track, Purse: Infinite Dreams & Budget Surprises — 14 runners, post time: around 7 PM Saturday, after Rutgers walk-over. Weather clear, track fast.

LATE SCRATCHES — Eli Drinkwitz got a new, 6-year contract at Missouri, so scratch Drinkwitz! Clark Lea reportedly has a new, 6-year contract at Vandy. Scratch Clark! We’ve recalibrated the odds to reflect the late scratches.

The Serious Contenders — Who Has a Real Shot

Let’s start with the horses that look like they’ve actually filed for the gate: Bob Chesney, Kalen DeBoer, Eli Drinkwitz, maybe Jeff Brohm or Matt Campbell — these are the horses you root for when you believe Penn State wants a stable, competent reboot without the fireworks or circus baggage. And let’s not forget Brian Hartline, who always seems to be the subject of speculation — until he isn’t.

• Chesney’s got that “rising-star underdog” aura. He’s been winning everywhere he’s coached, and recent reports show him climbing near the top of the candidate list. He hits the sweet spot: less splash, less ego, potentially more workaday coaching grounded in fundamentals.
• DeBoer brings the pedigree of a top program — high-stakes experience, proven success, and a résumé that commands respect. As long as he’s even loosely available, he’s the “safest big swing” option. But the big question, is why the hell would he leave Alabama for Penn State?
• Drinkwitz — seasoned, Power-5 experienced, familiar with the modern minefield of transfers/NIL — appeals if the brass wants minimize disruption and dodge the portal landmines.
• Brohm or Campbell have upside, though none inspire wild optimism among the primed-for-playoff crowd. Their appeal is steadiness, not fireworks. Brohm would be the choice for a more aggressive offense and constructive use of the transfer portal, while Campbell is a plodding culture-builder.
• Hartline is an interesting case. No head coaching experience, but a superb recruiter, and poaching from tOSU is always secretly satisfying for many PSU fans.

If PSU were building a reliable machine meant to survive attrition, attrition-adjusted expectations, and recruit churn, any of these picks could get you there — with different trade-offs in style, risk, and ceiling.

Why Terry Smith Looks Like a Long Shot

Now: the case for Terry. He’s not without appeal. He’s internal, knows the locker room, players like him, and his recent interim stint gave the fans one good night: a blowout over Nebraska, 37–10, with chants of “Terry! Terry!” from the stands. But — and this is a big but — that’s not enough to survive the modern college-football pressure cooker.

First, the landscape has changed. Recruiting, NIL, transfer portal — these aren’t side shows anymore; they’re main acts. Running a college program today is like running a business: budget management, talent acquisition (via high school and portal), donor/NIL balancing, instant-result expectations. A “culture guy” or “locker-room favorite” without a long track record of building rosters, navigating NIL/portal turbulence, and winning under high stakes — that’s a hard sell.

Second, tolerance for “growing pains” is minimal. Even a 9-win season might not satisfy fans and donors who now think “playoff or bust.” If Smith gets a two- or three-year contract and fails to produce immediate traction — recruiting-wise or win-wise — the backlash will be swift. Given that, hiring an unproven internal interim as permanent head coach seems more like a “bridge hire” than a foundation for a program rebuild.

Additionally, why would Pat Kraft go to the trouble of firing James Franklin so he could hire Smith, a “Franklin Guy”? Sure, Terry is making a valiant effort to distance himself from Franklin and paint himself as a “Paterno Guy”, but still…

Finally, long-term program building may demand an outsider — someone who brings a proven system, fresh recruiting pipelines, and perhaps outside-the-box thinking. Smith’s familiarity is a strength — but in a landscape that’s pivoted hard toward financial arms races and talent shopping, familiarity alone may not cut it.

My Take — If I Were Betting Real Money

If I were a gambler placing a wager on Penn State’s next big hire, I’d lay cash on one of the “modern-era” coaches: Chesney or DeBoer or Drinkwitz — depending how deep the brass wants to swing. I’d treat Terry Smith as more of a placeholder, a “if we can’t land anyone else” fallback. Long-term? I wouldn’t expect more than a season or two before the pressure cooker blows either way.

Timing — When the New Coach Likely Gets Named

• According to recent reporting, the regular season ends Saturday with the game at Rutgers, and the buzz is that a decision could come “as soon as next week”.
• That timing makes sense: with the early signing period opening December 3 and the transfer-portal window reopening January 2, Penn State will want the new head coach in place before the portal opens — otherwise recruiting and roster-management chaos could get out of hand.
• So yes — assume the new guy gets announced before the bowl game (unless something bizarre happens).

Who Coaches the Bowl Game — and What Happens if the Hire Happens After

• If the new head coach is hired before the bowl game, he may either take over immediately or defer day-to-day coaching to the interim / coordinators, depending on how quickly he wants to install his staff and system.
• If the hire happens after the bowl game — not impossible if the search drags — then the bowl game likely gets run by the current interim staff (led by Terry Smith) or whoever the administration designates as temporary caretaker.
• Given the need to stabilize recruiting and handle portal/NIL issues — and given the sense from insiders that the school wants to move fast — I lean toward a pre-bowl announcement.

What’s In Play for Terry Smith & Current Coordinators

If the new hire comes in soon, Smith and perhaps some coordinators face a rough transition:

• Smith — currently interim head coach — will almost certainly be out unless the new boss sees value in retention. Given how speculation has framed him (as a “bridge / fallback”), I doubt he stays.
• Coordinators and other staff could be reworked too. A new head coach brings new staff, new schemes, and new loyalties. Some may be kept, but many could be let go (especially if they’re closely linked with the previous regime).
• If the bowl game happens under Smith (or interim staff), and the result is ugly — or if recruiting / portal fallout is immediate — that could accelerate turnover.

What Fans & Boosters Are Watching — Short-Term and Long-Term Stakes

• Short-term: bowl performance, first statements from the new coach, early recruiting moves, re-assurances to donors/NIL-backers, and stability during the portal opening.
• Long-term: whether the new regime can field competitive teams with roster churn; whether they attract and integrate portal transfers intelligently (not just splash NIL-driven signings); whether they can rebuild a sustainable program identity — something you’ve criticized in the past as being effectively dead.

Da Bottom Lion — No Easy Choices, But Timing Is Everything

If I were running the books: I expect the new Penn State head coach to be announced within a week of Rutgers — well before the bowl game and before the portal opens. That means a swift turnover for Smith and some of the current staff. The bowl game could either be a “welcome wagon” for the new boss (if hired early), or a swan song for the interim regime — which, if things go south, could accelerate a broader cleanup.

The coming few weeks will be high-stakes — for players, coaches, boosters, and fans alike. Be ready for some fireworks, not just fireworks-style hype. Because nothing says “Happy Holidays” like firing assistants, repelling portal raids, and watching boosters throw money around like a QVC cult meeting.

The Turkey made it through Thanksgiving, so I will indeed darken your door after the Rutgers game. Maybe we’ll know something by then!

The post Penn State Head Coach Derby appeared first on The Nittany Turkey.

Two Big Ten also-rans meet in Piscataway on Saturday to determine who has Toilet Bowl eligibility, and who goes home for the holidays. Wowzer! We’re looking at post-Thanksgiving anti-climax, where the best thing going for us is our turkey coma. (In this Turkey’s cannibalistic Thanksgiving venture, the coma concept is karmic, but I digress).

Penn State dominates the all-time series with the State University of New Jersey 32-2 and have won 17 straight. The Nittany Lions are currently two-touchdown favorites to win this annual pseudo-rivalry game with their neighbors to the east, the alma mater of former porn queen Asia Carrera.

Expect to see lots of Kaytron Allen and Nick Singleton once again. If Allen does not get 25 carries, I’ll eat your cranberry relish and die in a diabetic non-Turkey coma. Expect him to top 4,000 career yards in this game, something done by only 22 other Big Ten players in the long history of the conference.

Rutgers Home Boys

Rutgers is led by senior quarterback Golden Greek Athan Kaliakmanis, who has thrown for 2,786 yards with 17 touchdowns and 7 interceptions this season. His completion percentage is decent, at 61.6%. His favorite target, wide receiver KJ Duff, is closing in on 1,000 yards on the season, with 17.4 ypc and 6 touchdowns. Meanwhile, 1,000+ yard sophomore rusher Antwan Raymond from Montreal provides much of the ground game, averaging 4.9 yards per carry and scoring 12 touchdowns in the 2025 campaign.

So, who wants the Toilet Bowl trip more? This might be decided by simple mo analysis (SMA). Penn State has the momentum, having won impressively against Nebraska last week 37-10, while Rutgers was busy losing to the Schmuckeyes 42-9. Terry Smith has created energy, cohesiveness, and enthusiasm among the troops, which says a lot. I expect it to continue.

Da Wedda

It’ll be a cool, sunny day in Piscataway, with a high of 45. Still football weather, but wind gusts to 22 mph might play havoc with the Scarlet Knights two field goal attempts.

Da Bottom Lion

Welcome to the final Official Turkey Poop Prognostication for the regular season. We should be hearing from the Penn State coaching search committee (namely, Pat Kraft), shortly after this game, assuming they have unearthed any decent candidates for the job. So, the game and associated bowl eligibility kinda play backseat to the big decision.

I’m looking for Penn State’s team leaders to keep things going from last week. (Funny how the winds of fortune change around here, ain’t it?) Gamblers are looking at a 34-12 break-even with Penn State on top. I see the Nittany Lions covering the spread here and making their closing argument, which will surely land them a spot in a cold-weather bowl. Penn State 42, Rutgers 6.

Happy Thanksgiving, All! See you after the game.

The post Scarlet Billows, 2025 Edition appeared first on The Nittany Turkey.

Greetings, long-suffering Peptide Purgatory readers! Your favorite Mounjaro/Farxiga lab rat is here with another lengthy, boring issue for you. Self-disparagement aside, I hope some of you can benefit by reading my thoughts on the latest news about our GLP-1 RA medicated society.

And speaking of GLP-1s in the news, thanks to this miracle incretin, Eli Lilly now rivals the high-tech high-flyers as a trillion dollar corporation. During the week, Lilly’s market capitalization exceeded that magic, 13-digit threshold. How’s that for opportunistically converting the modern world’s deadly embrace of quick fat-loss cures to cash!

Who in the Mounjaro Am I?

In other notable news this past week, I turned 79 years-old. Yeah, this Nittany Turkey, pictured at left at my AI-enhanced best, is a foul old fowl, indeed, about to bunker in to avoid the Thanksgiving chopping block that will be the fate of so many of my relatives. Along that long life’s pathway I’ve accumulated my share of old bird afflictions, notably metabolic syndrome, Type 2 diabetes, chronic kidney disease, osteoarthritis, gout, erosive gastritis, and nine million other major and minor ailments. I’m taking Mounjaro for the diabetes, Farxiga for the CKD, and a couple of other drugs. While I believe I benefit from Big Pharma’s finest money-making drugs, I frequently use this space to disparage their profit-motivated market manipulation, spurred on by their government buddies and the willing collaboration of the captive medical associations.

In This Week’s Issue

This week, we look at current research that continues to hammer down the proven fact that GLP-1 drugs cause loss of beneficial muscle mass along with the desired fat loss. To combat the muscular attrition, we must diligently pursue strength training while taking these drugs or we wind up living the final years of our lives frail and helpless. I’ve taken this aspect of GLP-1 RA therapy very seriously: Since starting on Mounjaro in June 2024, I’ve been pumping iron like Arnold and crusading for others in my position to pay more attention to their muscles. Use ’em or lose ’em!

I typically include tidbits from my personal health story to further bore you all (but, hell, writing them is therapeutic for me). If your attention span permits, you’ll see my cognitive testing results from the SOMMA research study. I felt I screwed it up because I took the test by phone on a very busy morning. So, checking it our might confirm your suspicions about my mental acuity. On the other hand, despite the less-than-perfect score, you’ll see that I still can juggle a shitload of mentally taxing tasks in my daily life.

Also in this issue, Bullshit Corner takes a piss on RFK, Jr. and his captive CDC removing the research-based statement that no proven connection between vaccines and autism exists. This wreckless bungle opens the door for RFK’s plaintiff-bar buddies, as well as endangering our babies. Join us for a cynical look inside the YouTube influencer-run madness of the HHS clown car under RFK Jr.

So, sit back, grab a donut (which you can now pee out if you take some Jardiance), and enjoy!

Muscle Matters More Than the Scale

GLP-1s, Lean Mass, and How Not to Shrink Your Quads for Science

If you listen to the GLP-1 hype machine, you’d think the only number that matters is how many pounds fall off. TikTok: “Down 20% bodyweight!” Reality: “And 25–40% of that was lean mass, champ.”

A recent Healio piece made the point bluntly: yes, these drugs burn fat like a flamethrower — but some of what disappears isn’t fat. The question is whether you’re shedding acceptable “support structure,” or quietly trading diabetes for frailty.

Lean Mass: Not Just “Muscle,” Not Just Vanity

DXA doesn’t isolate muscle; it counts:

• skeletal muscle
• organs
• connective tissue
• and a whole lot of water

So when you hear that 25–40% of weight lost on semaglutide or tirzepatide is “lean,” part of that is simply shrinking fluid compartments as fat melts. But part of it is muscle and bone — the stuff you need to stay upright and avoid breaking like a breadstick.

How Much Are We Losing?

The trials say:

• Tirzepatide (SURMOUNT-1): ~25% of lost weight = lean
• Semaglutide 2.4 mg (STEP-1): ~39% = lean

If you drop 50 pounds on semaglutide, you might lose ~30 lb fat and ~20 lb lean. For someone going from 350 to 260, that might be fine. But for older adults, the frail, the osteopenic, or anyone who’s already wobbling on the edge of sarcopenia, that’s a real problem.

Kashyap notes unpublished data showing ~10% hip bone loss in 17 months on an incretin. That should make anyone over 60 sit up (carefully). [How long have I been on Mounjaro? Coincidentally, 17 months. –Ed.]

Pharma Smells Opportunity

The minute someone whispers “muscle loss,” biotech startups come sprinting in:

• Bimagrumab + Semaglutide: 22% weight loss, minimal lean loss
• Trevogrumab + Semaglutide: lean loss cut in half
• Apitegromab + Tirzepatide: preserves ~4 lb of lean mass

Translation: “We fixed your weight loss; now we’ll sell you the muscle-protection DLC.”

Problem: we have absolutely no proof whatsoever that these combos improve function. Right now, it’s just prettier DXA scans and better p-values.

The Boring Stuff That Actually Works

The lifestyle advisory from obesity and lifestyle-medicine societies is the part everyone ignores because it’s not sexy:

• Protein: 1.2–1.6 g/kg/day
• Strength training: at least 3×/week
• Aerobic work: ~150 minutes/week

These work because drugs don’t decide what you lose — your behavior does. GLP-1s suppress appetite; they don’t send a memo to your quads saying, “Don’t worry, we’ll spare you.”

The Real-World Way to Not Become a Frail GLP-1 Success Story

1. Treat your muscle like critical infrastructure.
Goal is not “lighter at any cost.” It’s less fat, same or better strength.

2. Don’t inadvertently starve yourself.
GLP-1s make under-eating easy. Under-eating makes muscle loss inevitable.

3. Hit your protein like it’s medication.
Spread it across meals. Each one should trigger protein synthesis, not pity.

4. Lift heavy-ish things.
Push, pull, hinge, squat, carry. The compound load-bearing movements that keep you from becoming a fall statistic.

5. Watch function, not vibes.
If stairs get harder while weight drops, you’re losing the wrong stuff.

6. Be skeptical of expensive biologics until they prove functional benefit.
Saving 4 lbs of lean mass on paper means nothing if you still can’t get off the toilet without using momentum and prayer.

Bottom Line

GLP-1s are phenomenal for diabetes and obesity. But they’re agnostic about what you lose. You have to supply the stimulus that tells your body:

Keep the muscle. Keep the bone. Burn the fat.

Muscle isn’t vanity weight — it’s your glucose disposal system, your metabolic gearbox, your anti-fragility hardware. The drugs are the miracle; protein and barbells are the engineering that keeps the miracle from collapsing.

And around here? You know damn well which side I’m on.

Meanwhile, Back at SOMMA… (Now With 79 Years of Superiority)

While the rest of the SOMMA participants were shuffling into the cognitive testing dungeon like extras from a low-budget zombie flick, your soon-to-be-79-year-old correspondent sauntered in, casually posted a 27 out of 30 on the MoCA, and walked out without even breaking a synapse.

I had been concerned that I screwed up the test. I know I could have done better. When they asked if I was in a quiet place with no distractions, I lied. That morning had been a comedy of interruptions at inopportune times, and I was still mentally juggling the day’s priorities when the scheduled cognitive testing call came.

Well, apparently, I did better than I thought I did, which would be good enough for some old farts, but still disappointing to me. If you insist, though, I’ll gloat about it.

The Mind/Body Connection

I keep telling everyone strength training pays off, and now we have proof: somewhere between the deadlifts, the monster walks, and the leg presses that would make a 40-year-old rethink his life choices, my brain apparently decided it should try to keep up. Neuromuscular adaptation? Hell no — neurovascular domination. At this point, every barbell I lift probably generates enough BDNF to power a small research lab.

And it’s not like I’m strolling through life carefree, eating bonbons and solving Wordle.

I have cognitive load that would bring a lesser, 79 year-old mortal to his knees:

• Negotiating the ACA insurance labyrinth, where the reward for hours of navigating contradictory government websites is the privilege of paying a thousand bucks a month so my not-yet-Medicare-eligible wife can be assured of catastrophic coverage if she ever needs it (and maybe a “free” gym membership).
• Bracing for the inevitable “Medicare Solvency Plan,” which will raise eligibility to 85 — conveniently just after she turns 65.
• Performing my weekly duties as Awards Secretary of a national ham radio organization, herding directors, soothing officers, writing five-year plans that actually require five brain cells to read, and championing fee increases like some geriatric Alexander Hamilton.
• Coexisting with Big Pharma, the PBMs, Dr. DeLorean, Dr. Macallan, and all the other characters in the ongoing medical sitcom that is my life.
• Managing a workout schedule that would make an Olympic trainer say, “Sir, please sit down, you’re making us look bad.”
• Designing networks, running APRS experiments, patching Proxmox clusters, and keeping eight computers, multiple VLANs, and a FlexRadio behaving.
• Maintaining a dozen or so Geocaches involving serious bushwhacking that is far less of a strain than is dealing with inflexible bureaucrats in the Florida Department of Environmental protection.
• Writing a twice-weekly column about Penn State football, especially in a season everybody would prefer that we permanently erase from our memory banks.
• Living in a toxic HOA environment with multiple warring factions clamoring to either depose the President or put him in jail. Yea, verily, a neighborhood where “Signgate” approached Watergate proportions in the annals of HOA history and where every YIELD sign is a comedy act.

And still:

Twenty-seven out of thirty.

The SOMMA team should be studying me as a confounding variable. Hell, the statisticians probably had to huddle afterward to determine whether to classify me as an outlier, a mutant, or a rounding error in God’s spreadsheet.

Let’s face it:
What I call “screwing up” is what most people would proudly frame on their refrigerator next to their kid’s participation trophy.

So when this piece hits Peptide Purgatory, your humble narrator will have officially completed 79 laps around the sun, each one apparently sharpening my cognitive edge while everyone else is losing their car keys inside their own pockets.

I’d say “I hope that reassures my readers,” but let’s be honest — most of them have already fled.
The remainder are here for the spectacle, and I’m just here to blow my own damn horn for a while.

And I aim to keep delivering.

Expanded Bullshit Corner

And now, the feature you’ve all been waiting for. Bullshit Corner takes a cynical stab at the latest Trump Administration unabated HHS circus, captained by the plaintiff bar’s favorite partner, Ringmaster RFK, Jr.

Wrapping It Up: Smaller, Weaker, Dumber Is Not the Goal

So that’s this week in our brave new incretin world:
Wall Street is throwing confetti at Eli Lilly for turning GLP-1s into a trillion-dollar cash printer, the medical-industrial complex is still pretending muscle is optional hardware, and RFK Jr. is busy converting the CDC into a content partner for his antivax fan club.

Meanwhile, in the real world, the trade you’re being quietly offered is simple:

• We’ll shrink your waistline.
• In exchange, we’d like some of your muscle, a chunk of your bone density, and maybe a little bit of your common sense if you start taking YouTube medicine seriously.

If you’ve made it this far into the issue, you probably already suspect that’s a bad deal.

The gist is not complicated:

• GLP-1s and tirzepatide can be incredibly useful tools for diabetes and obesity.
• They do not care what you lose — fat, muscle, or bone.
• Your muscles, bones, and brain are your responsibility. That means protein, iron, barbells, walking speed, and occasionally saying “no” when the scale looks great but your legs feel like overcooked pasta.

I’m 79, allegedly cognitively intact, and still annoying enough to write all this instead of quietly fading into Medicare brochures. If there’s a point to this whole Peptide Purgatory enterprise, it’s this:
Use the drugs if they help you — but don’t abdicate the parts of your health that Big Pharma, RFK, or TikTok are never going to fix for you.

Muscle matters. Balance matters. Brains matter. The rest is just billing codes and stock charts.

Thanksgiving Send-Off: Congratulations, You’re an Endangered Species

If you’re still reading, congratulations: you are now part of a critically endangered subspecies — the Adult Human With an Attention Span Longer Than a Reels Clip.

You’ve survived:

• A lecture on lean mass and GLP-1s,
• An old man flexing his 27/30 MoCA like it’s a Super Bowl ring, and
• A full tour of RFK Jr.’s Department of Health and Harm Services, featuring a supporting cast of YouTube grifters and supplement peddlers.

For this, you earn my deepest respect and absolutely no tangible reward.

Here’s your homework until the next issue:

• Lift something heavier than your phone.
• Eat enough protein to keep your quads from entering hospice.
• Treat any federal website that suddenly sounds like a podcast guest with the suspicion it deserves.
• And if you’re on a GLP-1, remember: the drug can curb your appetite, but it doesn’t get to decide what kind of old person you become. You do.

Thanks for slogging through another overlong installment of Peptide Purgatory.
Now get out of your chair, go move something, and try not to let the CDC, RFK Jr., or Eli Lilly make you both smaller and weaker.

Until next time,
— Your foul old fowl, still lifting, still bitching, still here.

HAPPY THANKSGIVING TO ALL MY TURKEY READERS AND MY FALLEN HOKIE COMRADES!

Peptide Purgatory chronicles one man’s ongoing experiment with Mounjaro, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia while reading policy papers. So, ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: Lose Weight, Not Muscle, plus My Brain and RFK, Jr. appeared first on The Nittany Turkey.

A Breath of Fresh Air, Already!

Let’s dispense immediately with the inevitable mouth-breathing chorus of, “Well Nebraska sucks without Raiola. (Maybe even with him).” Spare me. What this Terry Smith–led Penn State team did was take the weak, thready pulse we barely detected in the second half against Moo U. and turn it into an actual heartbeat. Hell, an honest-to-God Lion’s heartbeat. Didn’t expect that, did you?

Kaytron Allen: The Record Book Just Got a New Tenant

Smith’s plan was simple: run the damn ball. And holy hell, did they.

Kaytron Allen delivered exactly the kind of performance we all hoped he’d still had stored somewhere beneath the wreckage of this season: 25 carries, 160 yards, two touchdowns, and the all-time Penn State rushing record to boot. Not a bad day at the office.

Nick Singleton did his part too, rewriting a line of the record book with two rushing TDs, while putting up 44 yards on the ground and another 51 receiving. Most of that came courtesy of a gorgeous 50-yard catch-and-run that momentarily reminded us what competent offense looks like.

The Passing Game: Short But Sweet

Facing the #3 pass defense in the FBS, you’d expect Penn State’s aerial attack to be about as lively as a morgue. And yet — behold — Ethan Grunkemeyer only threw 12 passes but completed 11 of them for 181 yards and a touchdown.

Take THAT, #3 pass defense! Sometimes less really is more.

The Defense: Wait… Tackling?!

True freshman TJ Lateef came in with cartoonish passing stats. He left with a bruised QB rating and probably some hurt feelings.

Lateef went 21-37 for 187 yards, was sacked three times, and “rushed” for 15 yards on 10 carries, which is a polite way of saying he ran into traffic a lot.

The defense actually remembered how to wrap up, though of course they still gave up their standard 300+ yards — because some traditions must be preserved.

After the game, players held up professionally printed HIRE TERRY SMITH signs, the kind that don’t get made in the student section with a Sharpie. Ah yes — the spontaneous, heartfelt expression of a commercial vendor. More on Terry Smith below.

The Terry Smith Dilemma

In a different era — say, 1958, before college football crawled into its current cesspool — hiring Terry Smith would be the easiest decision since “run the ball on 3rd-and-2.”

• The players respond to him.
• The team clearly believes in him.
• He’s a Penn Stater.
• His game plan tonight worked.
• He exudes leadership and loyalty.

Perfect, right?

If only college football weren’t currently a festering, money-soaked, NIL-driven bacchanal where head coaches are expected to function as CEOs, lobbyists, fundraisers, recruiters, spin doctors, and occasional tacticians. The head coach today needs:

• A brand
• A PR machine
• Donor-handling skills
• Recruiting charisma
• High-end staff connections
• And, yes, a willingness to crawl on broken glass for NIL sugar daddies

Terry Smith is a good coach and a good man — but he’s a throwback to when college football was actually about college football.

That man deserves more than being fed into the wood chipper of 2025 athletics because Penn State bungled the Franklin firing and started a coaching search with all the planning of a drunken canoe trip.

“He can grow into the job!”

No.

This job requires instant political mastery, instant national credibility, and instant NIL swagger. You don’t get a learning curve in this era. You either walk in the door ready to run a Fortune 500 football enterprise… or the donor class eats you alive.

Hiring Terry Smith wouldn’t be a romantic return to our roots.

It would be a panic hire borne of desperation, one destined to end in a two-year firing cycle that ruins the man. And he does not deserve that fate.

So no, I don’t want Terry Smith to be the next head coach. I want him to stay the hell away from the blast radius of the coming administrative stupidity.

Who Should Be the Next Coach?

Honestly? Doesn’t matter.

You could resurrect Knute Rockne from the grave and he’d take one look at NIL contracts, transfer windows, booster collectives, agents, bidding wars, and the 17-year-old mercenaries calling themselves “student-athletes,” then hop back in the coffin and seal the lid from the inside.

The game is no longer about alma mater or loyalty. It’s a full-blown semi-pro free agency market disguised as an educational endeavor.

Penn State is in the same morass as everyone else. The sport has become transactional, cynical, mercenary — and that’s me being polite.

Knute Rockne isn’t just rolling over in his grave. He’s rotating like a high-RPM turbine.

Assuming I survive Thanksgiving — and that’s a big IF (thank you Terry Smith) for a Turkey — I’ll return during the week for a look at the season’s anticlimax with the Scarlet Billowing Knights.

The post HIRE TERRY SMITH (Not!) appeared first on The Nittany Turkey.

Somehow, the network executives decided this turd was worthy of prime time. Sorry, America. Those not watching Florida–Tennessee or The Big Game may wander over for a few minutes before realizing they’ve made a terrible life choice. But hey, the 7 PM start gives me more time to write, which is good, because I’m suffering from terminal Shitty Season Fatigue. The only silver lining I can muster is that this infamous but forgettable year is nearly — mercifully — over. One more snoozer next week, then into the ditch we go. If we’re lucky, we’ll avoid a Toilet Bowl invitation so we don’t have to be humiliated on some obscure streaming service in front of 11 people.

Senior Day: Because someone has to turn out the lights.

What lies ahead is a freshman QB duel: Nebraska trotting out true freshman TJ Lateef, and Penn State rolling with redshirt freshman Ethan Grunkemeyer. They’re roughly the same size, both four-star recruits, and both inherited starting duties from the fallen warriors who started their seasons with dubiously high expectations.

Lateef has played in four games and boasts a ludicrously high 85.3% completion rate with four touchdowns and zero interceptions. Oh, and he can run — 81 yards and two TDs on the ground. (Circle that one in your diaries, Turkey fans, because it will mean something tonight). Meanwhile, Grunk is at 64.9% through eight games, with four touchdowns and four interceptions and runs with the speed and grace of a cinder block. A cinder block behind five traffic cones? Who knew?

Aside from the QB, What Have We Got?

Nebraska’s pass defense is #3 in the FBS, and Penn State’s passing game is functionally a rotary phone in an iPhone world, so expect a steady diet of Kaytron Allen and Nick Singleton. Whatever scraps remain of Penn State’s offensive brain trust appear allergic to “passing” as a concept and haven’t figured out how to use their million-dollar receivers, who in turn have forgotten how to get open. Thus: Allen 25 touches, Singleton 20 touches, and an afternoon of “three yards and a cloud of ennui.”

We’ll probably see a smattering of “interesting” formations and plays from Andy Kotelnicki’s Offensive Catalog of Frequently Busted Plays. Truly offensive.

Meanwhile, Penn State’s unpredictable but reliably porous defense — which seemed to quit before the Moo U. game, then briefly remembered how to tackle — will attempt to pressure the freshman. And because this staff never learns, they’ll forget to assign a spy on Lateef, and he’ll gash them repeatedly. Old habits die hard, and bad defenses cling to life like mold on shower grout. Or maybe in my case, Serratia marcescens, the pink stuff.

Odds Jim Knowles is apartment-hunting in Blacksburg before Christmas? Nonzero.

The Terry Smith Delusion Cycle

Interim HC Terry Smith received a glowing endorsement from President Neeli Bendapudi, who remains blissfully unfamiliar with the meaning of the word “soonest.” Players love Smith, and many Sanguinarians — heads firmly lodged where the sun definitely doesn’t shine — think retaining him is the mythical second coming of Mike Munchak. But you and I know Smith will land this job only if the coaching search becomes a total grease-fire of desperation. He might get it by default, but he’d enter the position already measured for the custom-tailored hot seat.

Pat Kraft? Overestimated himself, underestimated the job, classic narcissist storyline. As for the next HC? Good luck. Who wants to risk their career salvaging a once-proud but now structurally wobbly program, only to get canned two years later because they failed to meet the unreasonable delusions of fans and NIL sugar daddies?

A Lawless Carnival of Cash Grabs

College football is now a lawless carnival of cash grabs. If Trump didn’t have another gig, he’d be my pick as commissioner — just to bring some honesty to the graft. Our new cheer for the Epstein Island All-Star Cheer Squad:

Gimme an M!
Gimme an O!
Gimme an N!
Gimme an E!
Gimme a Y!
WHADDYA GOT?
NFL LITE!
YAAAAAAY!

Michigan–Ohio State in Tokyo? Give it three years. The NCAA will rename itself “NCAA Presented by Saudi Aramco.”

So does it even matter who Penn State hires? Does any “big name” actually want to step into this mess, even for all the tea in China (or all the oil in Arabia)? Is any coach greedy or delusional enough to believe they can fix this in the era of endless transfers, NIL bidding wars, and fans who think 1994 is repeatable if you scream loud enough?

Iowa fans are content with Kirk Ferentz on the 30-year plan. Penn State once embraced Paternal (get it?) stability. Now we’re addicted to champagne dreams on a Thunderbird budget, imagining a National Championship every year because we cut a fat check. Where the hell did tradition go? Values? Sanity?

But hey — I digress.

Da Wedda

High 30s, 60% chance of precipitation. Translation: empty seats as far as the eye can see. Who wants to freeze off important body parts to watch this joyless slog? If it rains, expect that cold, miserable drizzle that penetrates your soul and convinces you to rethink your fandom. With both teams leaning run-heavy, you may slip into hypothermia and boredom simultaneously. At least the ambulance ride will break up the monotony.

Da Bottom Lion

You survived my rant about college football’s descent into the sewer and the delusional expectations of Penn State fans. Congratulations. Now, as we fervently pray for no post-season, it’s time for the regular season’s penultimate Official Turkey Poop Prognostication — that awful offal steaming straight from the malodorous cloaca of this foul old fowl. And with Thanksgiving looming, I’ll be hiding in my bunker hoping Trump pardons me again. One wrong move and I’m drumstick-deep in the Swift Butterball processing line. No thanks.

Penn State is favored by 7.5. Don’t ask me why. Maybe it’s the weekly Sanguinarian betting distortion, or maybe Vegas just hasn’t watched the Nittany Lions play. Over/under: 45.5 — the oddsmakers signaling, “Don’t expect much offense, you degenerates.”

Gamblers’ score: PSU 26, Nebraska 20.

My score: Nebraska 26, Penn State 20. Low-scoring, run-til-you-snore, and Lateef burning PSU’s ass on scrambles because why break the habit of a lifetime?

There you go.

A perfect Senior day for a perfectly putrid season.

I’ll be back after the game with sparkling insights into what promises to be a less-than-sparkling performance by two has-beens.

The post Senior Day Battle of the Wimps appeared first on The Nittany Turkey.

James Franklin didn’t stay unemployed long enough to finish his buyout math. One month after Penn State handed him a pink slip and a heavily discounted golden parachute, he’s now the freshly anointed CEO of Virginia Tech’s semi-pro football operation in Blacksburg.

And in a twist fit for a soap opera, he’s taking over the job vacated by his longtime lieutenant Brent Pry, who was fired in September after an 0–3 start and a 16–24 run that made Hokie fans nostalgic for the halcyon days of losing 24–20.

So what happens now? Three storylines matter:

1. The Franklin–Pry relationship and whether Pry could really crawl back in as DC at the same place that just canned him.
2. Which assistants Franklin might poach from Penn State, potentially before this season staggers to the finish.
3. How aggressively he’ll work the recruiting board, especially kids he once sold on Happy Valley who might now be convinced that Blacksburg is just Happy Valley with turkey legs and Enter Sandman.

Let’s dive in.

Franklin and Pry: From Wingman to “Thanks for the House, I’ll Take It From Here”

Brent Pry isn’t some random retread; he’s basically Franklin’s defensive shadow. They worked together for more than a decade at Vanderbilt and then Penn State, where Pry rose from co-DC/LBs to full defensive coordinator and helped build the defenses that kept Franklin’s “complementary football” sermons from turning into full-scale riots in Beaver Stadium.

When Pry finally got the Virginia Tech head job in 2021, it was widely read as Franklin placing his guy in a historically defense-first program that needed a cultural reboot. He talked Beamer-era lunch-pail nonsense, tried to rebuild the 757 and DMV pipelines, and leaned into the “Hokie DNA” stuff hard. Results? Mixed on recruiting, ugly on the field. Two bowl trips, one Military Bowl win, but no real momentum — and this year’s 0–3 faceplant, capped by Old Dominion hanging 45 on the Hokies in Lane Stadium, sealed his fate.

Franklin, to his credit, was publicly supportive when Pry got canned, calling him a friend first and a colleague second. That’s genuine; these guys have logged a lot of hours together.

But friendship and staff chemistry are one thing. Bringing Pry back as defensive coordinator at the school that just paid him millions to stop running their football program is something else entirely.

Could Franklin really bring Pry back as DC at Virginia Tech?

Short answer: in Year One? Almost certainly not.

Sports Illustrated’s Hokies site went right at the message-board fantasy: Pry as DC under Franklin. Their conclusion: hilarious idea, terrible timing. It’s a “fresh wound” for both the fanbase and the locker room. Many of the same players who looked like they’d mentally checked out at the end of Pry’s tenure are still there; asking them to now call him “Coach” again, even with a different title, is begging for drama.

On top of that:

• Optics for the AD/boosters: They just sold “we had to fire Pry to change the trajectory of the program.” Turning around and rehiring him as DC — while cutting an eight-figure check for his buyout — looks like they fired him for the crime of being mis-titled.
• Pry’s own ego: It’s one thing to go back to being a coordinator somewhere else. It’s another to go back as DC at the same school that just told you you weren’t good enough. That usually requires either a multi-year cooling-off period or a serious lack of better options.
• Franklin’s leverage: Franklin didn’t jump back into the game to be sentimental. VT just committed hundreds of millions to athletics and football infrastructure precisely so he could go get top-shelf coordinators without having to recycle scarred local inventory.

Could Pry end up as DC somewhere under Franklin down the road — maybe after a year in TV, an analyst role in the NFL, or a defensive consultant sabbatical? Absolutely. Franklin trusts him, Pry knows the system, and as a DC he’s still highly respected.

But Pry to DC at Virginia Tech immediately is more fan-fiction than realistic hire. Even the VT-friendly SI piece essentially laughs it off as a “low likelihood” move right now.

Building the Hokie Staff: Who Does Franklin Steal From Penn State?

This is where it gets fun — unless you’re Terry Smith trying to hold together what’s left of Penn State’s program with duct tape and a whistle.

The core Franklin entourage

Franklin travels with a politburo more than a staff, and some of those people might as well have “permanent carry-on” stamped on their foreheads.

Sports Illustrated laid out the short list of non-on-field staff who are almost certainly gone from Penn State and headed for Blacksburg:

• Chuck Losey – Strength & Conditioning czar: The de facto second head coach in any modern program. He followed Franklin from Vanderbilt to Penn State and has already said, in so many words, that where James goes, Chuck goes.
• Kenny Sanders – Director of Player Personnel: Glue guy for recruiting logistics and relationships. If Franklin wants to rebuild VT’s DMV/Tidewater pipeline in a hurry, Sanders is the kind of behind-the-scenes operator who makes that happen.
• Andy Frank (GM of Personnel & Recruitment) and Kevin Threlkel (Chief of Staff): Longtime lieutenants who’ve been with Franklin since Vanderbilt. SI rightly notes that if Franklin has “buried bodies” in this sport, those two know where the shovels are. They’re almost certainly punching their ticket to Blacksburg.

None of those guys require Penn State’s permission the way an on-field assistant might mid-season, and they’re exactly the people Franklin will want in place as VT barrels toward the portal window and the December signing period.

On-field assistants: who’s poachable?

On the coaching side, Franklin has a few obvious targets, but also some constraints:

1. Coordinator roles at VT will be big carrots.
   Virginia Tech media have already speculated that Franklin could go after Jim Knowles, currently Penn State’s defensive coordinator (and formerly Ohio State’s DC for their 2024 national title). Knowles’ reputation as an elite play-caller makes him an easy name to circle.
   • The catch: Penn State, even post-Franklin, probably has a bigger assistant salary pool than Virginia Tech. If PSU’s next head coach wants Knowles, VT may have to overpay relative to its own history.
2. Position coaches with deep Franklin ties are vulnerable.
   A StateCollege.com breakdown and other reporting have flagged several on-field names as both loyal to Franklin and plausible flight risks:
   • Phil Trautwein (OL) – critical for the trenches, and VT has badly needed better line play.
   • Stan Drayton (RBs) – recruiting chops and player-development record.
   • Justin Lustig (STC) – special teams plus recruiting.
   • Danny O’Brien / Trace McSorley (QBs assistants) – younger staffers with close personal ties to Franklin and PSU’s recent quarterbacks room.
3. Terry Smith and Anthony Poindexter are wildcards.
   SI’s Penn State piece suggests that Terry Smith (now interim HC, long-time CBs coach) and Anthony Poindexter (safeties) are the two most consistently reliable assistants on that staff. Smith, being a PSU alum and now interim head coach, may hang around for continuity under the next guy… if he’s offered that chance. Poindexter has been hovering on the edge of head-coach candidacy for years.
   • Would Franklin try to pry Poindexter loose with a DC title at VT if Knowles stays put? That’s the kind of move that would simultaneously boost VT and gut PSU’s defensive brain trust.

Realistically, Franklin doesn’t need (or want) to hollow out Penn State completely — but you can bet at least a couple of position coaches and a big chunk of the off-field infrastructure will be wearing maroon before spring ball.

The Recruiting Fallout: Commits, Decommits, and Hokie Flips

Now to the meat: players.

When Penn State fired Franklin in October, the recruiting fallout started immediately. A four-star tackle from Harrisburg, Kevin Brown, already bailed on PSU’s 2026 class and committed to West Virginia, explicitly citing the coaching change.

StateCollege.com notes a few key realities:

• Penn State’s 2026 class has already lost more than half its commitments, with more teetering on the brink.
• The 2027 class, once ranked No. 1 nationally, now has zero members.
• There’s a list of underclassmen on the current roster — guys like Ethan Grunkemeyer, Daryus Dixson, Luke Reynolds, Koby Howard, Tyseer Denmark, and others — who are now priorities for both schools: PSU trying to keep them, Franklin trying to lure them to VT or at least keep them out of the portal until he can make his pitch.

What can Franklin realistically do from Blacksburg?

Mechanically:

• Current PSU players can enter the transfer portal once the FBS window opens after the season. They can do so sooner if PSU has already played its last game and a 30-day post-firing window applies. Franklin can’t legally tamper while they’re still on another roster, but let’s not pretend back-channel communication doesn’t exist.
• Commits who haven’t signed can decommit with a Notes app screenshot and go wherever they like. Franklin has long-standing relationships with many of these families. Shifting the sales pitch from “whiteout at Beaver Stadium” to “Enter Sandman at Lane Stadium” is just a matter of swapping the photos in the PowerPoint.
• Kids who already signed NLIs (early period) are trickier. They’d need to request releases or use the one-time transfer rule after enrolling. The timing of Franklin’s hire, just before the December window, gives him maximum leverage to get in front of both unsigned commits and portal-curious underclassmen.

Expect Franklin’s first VT class to be a Frankenstein mix of:

• Handful of flipped PSU commits, especially from Virginia, Maryland, and the broader DMV where Franklin historically recruited well and Pry couldn’t quite close.
• Portal vets with PSU ties, i.e., guys buried on the depth chart who trust Franklin enough to give him one more shot in a league with a softer path to the playoff.
• Local VT targets who suddenly find Blacksburg more appealing with a nationally known recruiter taking over and an “invest to win” war chest behind him.

For Penn State, it’s triage time: yet-to-be-named new head coach, decimated future classes, and your ex now running the only other program selling “come play big-time ball in a cow pasture” to the same mid-Atlantic kids.

So What Does It All Add Up To?

From 10,000 feet:

• For Virginia Tech: This is the biggest hire they’ve made since Frank Beamer’s heyday, and they know it. They just went all-in with real money, real facilities promises, and real NIL backing to hand the keys to a guy who, flaws and all, consistently built 10-win teams in a much tougher neighborhood.
• For Franklin: It’s a soft-landing rehab gig with upside. The ACC is a hell of a lot more forgiving than a Big Ten that now includes Oregon, Washington, USC, and UCLA. Go 10–2 at Tech and you’re a conquering hero instead of a message-board chew toy.
• For Pry: He’s probably not riding back into Lane Stadium as DC this winter. But the very fact that people are talking about that possibility tells you his reputation as a defensive mind is intact. He’ll resurface somewhere; it just won’t be back in Blacksburg under the same roof that fired him two months ago.
• For Penn State: You don’t just lose a head coach; you lose the ecosystem — strength staff, personnel brain trust, and, if you’re unlucky, a few of your best assistants and a chunk of your recruiting board to the same guy in a different colored hoodie. That new hire better be ready to work the portal and the high schools like a madman.

Da Bottom Line

Bottom line: Franklin to Virginia Tech isn’t just a coaching carousel blurb. It’s a tectonic shift that links three programs (PSU, VT, and whoever hires Pry next), two regions (PA and the mid-Atlantic), and about 50 teenage wide receivers posting cryptic eyeball emojis on Instagram.

Meanwhile, in State College, they’re about to find out the hard way whether firing the guy who kept going 10–2 was actually “unfair as hell,” as Nick Saban politely put it — or the necessary first step into whatever this new, even dumber era of college football is going to be.

The post Hokies Hire Franklin appeared first on The Nittany Turkey.

Welcome to the latest edition of Peptide Purgatory, a series that evolved out of my desire to share my Mounjaro experience with others of my ilk to what it has now become: a general catharsis of my disdainful relationship with the current healthcare morass in the U.S., replete with greedy corporate caregivers, greedy governmental gallutes, and us, the willingly complicit victims. This is an industry that regularly violates the spirit of the Hippocratic Oath for its own gain. Screw the patient — it’s all about the money!

I’ll eventually get back to my Mounjaro story, but having been stable for a few weeks, I have nothing interesting to report to you. I’m due for an iron follow-up and my hernia repair is scheduled in a few weeks, both of which will provide much fodder for self-absorbed bloviation here.

This Week’s Subjects

Meanwhile, I’m here to expose you to the wolves they try to cloak in sheep’s clothing — cleverly couched, of course, in my Turkeyesque, sarcastic manner, which was honed to a fine art writing about Penn State football. This week’s lead story is another poke at government and its friends, the profiteers in the healthcare industry, a collection of cads who attempt to delude the public regarding motive, while continuously screwing the patient in every way possible. The Affordable Care Act, The Inflation Reduction Act, and now, the grand deal pulled off by the Trump Administration and Big Pharma, all are examples of this “benevolence” by the government-industrial complex.

When someone shows up at your door with a smile saying, “I’m from the Government and I’m here to help you”, run the other way — and don’t bend over!

This week’s Bullshit Corner takes a poke at the medical industry coming down hard on the AI industry for regurgitating information fed to it — by none other than the medical industry!

Politicians, Pharma, PBMs, Compounders, and You

A few weeks ago, I took a flamethrower to the TrumpRx spectacle — that choreographed Oval Office moment where CEOs shuffled in behind the Resolute Desk like morally flexible garden gnomes and declared a “historic” breakthrough in lowering drug prices. I called it performative, transactional, and probably designed to enrich the usual cast of suspects.

Well, turns out I was only partially right.
The performative and transactional parts still hold.
But the enrichment?
That wasn’t petty corruption.

It was industrial-scale market engineering.

What we witnessed wasn’t the White House kneecapping Big Pharma — it was Big Pharma and Washington jointly constructing a federally sanctioned superhighway to the mass-market future of GLP-1 drugs.

This wasn’t reform.
This wasn’t cost cutting.
This was the Great GLP-1 Land Grab.

I. The Price Drop That Didn’t Happen

According to the Wall Street Journal, Lilly and Novo didn’t actually slash prices into oblivion.
They shaved 20–35% off the net, not the list price — the number that matters. In return, they get:

• Medicare coverage for obesity
• Access to tens of millions of new patients
• A federally anchored price floor
• A moat so wide Pfizer, Roche, Amgen, and every biotech startup will need scuba gear to cross it

Big Pharma didn’t lose money.
They traded margin for monopoly scale.

This wasn’t a truce — it was a territorial annexation.

II. Trump Didn’t Profit — He Bragged

In my earlier Bullshit Corner, I speculated that maybe the First Family stood to skim a little cream. Nope.

The truth is more mundane and more insidious:
This wasn’t personal graft — it was political theater.

Trump gets:

• a populist victory,
• a banner headline,
• and a talking point about “historic savings.”

Lilly and Novo get:

• the largest drug market expansion since statins,
• federally guaranteed demand,
• and effective cartel pricing power.

This is not corruption in the classic envelope-under-the-table sense.
This is the state endorsing a duopoly because it’s politically convenient.

III. Meanwhile, My Own PBM Experience Is Pure Absurdity

Now let’s talk about the part where this becomes personal — and revealing.

I am currently on two perfectly legitimate diabetes-tangential medications:

• Mounjaro (GLP-1/GIP) — for Type 2 diabetes
• Farxiga (SGLT-2) — for renal protection in CKD stage 2–3

Both are clinically valid.
Both improve outcomes.
Both are part of modern diabetes care.

Now look at how my Medicare Part D (Wellcare Value Script) treats them:

This is a pricing strategy only Kafka could love.

The $1,200/month GLP-1?
Practically free.

The kidney-saving SGLT-2?
A monthly shakedown.

This isn’t clinical logic.
This is the outcome of a political pricing scheme, PBM gamesmanship, and the gravitational pull of GLP-1 mania.

Medicare has essentially said:

“Take the GLP-1. Don’t take the kidney drug. Trust us — we know medicine.”

Ladies and gentlemen, this is what practicing medicine by proxy looks like.

SIDEBAR: Compounders — When “Shortage” Becomes a Business Model

The compounders and their telehealth partners made a fortune on semaglutide and tirzepatide knockoffs, thanks to two loopholes:

1. The “Shortage” Loophole

As long as Ozempic or Mounjaro appeared on the FDA shortage list — for any reason, real or imagined — compounders could legally crank out “semaglutide base” like it was bathtub gin during Prohibition.

Novo and Lilly sued.
Courts shrugged.
Compounders flourished.

2. The “It’s Mixed with B12 So It’s Totally Different” Loophole

By adding vitamin B12 (or electrolytes, or unicorn tears), compounders could claim they weren’t copying FDA-approved products — they were creating a “clinically necessary compounded formulation.”

Telehealth hustlers like Hims, Hers, and the army of VoIP “clinics” pushed these blends like they were selling commemorative coins.

Why This Party Ends Now

With brand-name GLP-1s dropping to $245–$350 cash prices, why would any sane person inject gray-market peptide soup brewed behind a vape shop?

The compounder gold rush is ending.
They’ll slink back to testosterone gels and “bioidentical hormones.”
The GLP-1 party was fun, but the sheriffs are in town.

SIDEBAR: PBMs — The Rebate Cartel Finally Takes a Hit

PBMs survive on one thing:
the spread between list price and net price.

The new GLP-1 pricing structure kills that.

When Lilly and Novo publish stable cash prices and Medicare adopts them, PBMs lose:

• the arbitrage,
• the rebate racket,
• and the opaque negotiation charade.

Employers will notice.
Insurers will notice.
Hell, even voters will notice.

PBMs can still reinvent themselves — they always do — but the GLP-1 repricing is the first existential threat they’ve faced in decades.

SIDEBAR: The American Consumer Is Complicit

Let’s stop pretending this was all the politicians’, PBMs’, and drugmakers’ doing.

GLP-1s are the populist drug of the decade:

• TikTok loves them
• Instagram worships them
• The wellness crowd prays to them
• Hollywood injects them
• Suburban Facebook groups evangelize them
• And Americans are lining up like it’s Black Friday at Best Buy

Nobody is clamoring for gray-market Farxiga.
Nobody is buying Jardiance out of the trunk of someone’s Corolla.

But compounded tirzepatide?
People will shoot that into a body part they can’t pronounce.

Public demand — loud, irrational, and relentless — shaped this entire landscape.

Politicians didn’t invent GLP-1 mania.
They surfed it.

Pharma didn’t create the cultural obsession.
They capitalized on it.

PBMs didn’t set the public narrative.
They bent their spreadsheets to it.

And now people like me get to pay $11 for the “sexy” drug and $250 for the kidney-saving one — because the cultural spotlight got its way.

Conclusion: The New American Metabolic Order

The political system, the pharmaceutical system, the insurance system, and the consumer base all conspired — willingly or otherwise — to make GLP-1s the next statins.

This wasn’t a price cut.
This wasn’t a reform.
This wasn’t a negotiation.

This was a market coronation.

• Politicians got a victory.
• Pharma got an empire.
• PBMs got exposed.
• Compounders got crushed.
• Consumers got their miracle shot.
• And the rest of chronic disease management bent around the gravitational pull of GLP-1 culture.

Welcome to the new metabolic America.
Inject responsibly — and keep your kidneys insured.

Well, there you have it. Our nanny-state government abets Big Pharma profits, making hay while the sun shines, under the guise of helping fat people, who are in turn being shamed by AI. Yea, verily, let’s all point fingers at red herring excuses while the fat cats reap big profit from fat humans who are seeking desperation cures for what modern society and its inherent indolence have wrought. The decline of personal responsibility is now an institutionalized reality, and there’s big money in it!

Peptide Purgatory chronicles one man’s ongoing experiment with Mounjaro, metabolism, and medical modernity. Side effects may include sarcasm, elevated skepticism, and mild tachycardia while reading policy papers. So, ask your doctor whether Peptide Purgatory is right for you!

For an annotated catalog of all my Peptide Purgatory and Mounjaro updates, visit my Mounjaro Update Catalog page.

The post Peptide Purgatory: The Great GLP-1 Land Grab and Adipophobic AI appeared first on The Nittany Turkey.

On a windy day in East Lansing…

Nah, I’m not going to lead in to this story with that trite bullshit. Penn State spoiled its perfect 0-6 Big Ten season with a somewhat unexpected win over Moo U., ending its longest losing streak in 20 years. Sanguinarians unite! There is hope!

Hope for what, I don’t know. With two games remaining for a rudderless ship captained by a temp employee and a vestigial staff that has proven itself incompetent through most of the season, a merciful end is the best hope. Oh, well, maybe Kaytron Allen taking a shot at eclipsing Evan Royster’s rushing record will give us some excitement.

But PSU can no longer aspire to being the worst winless team in the Big 10. Moo U. and Purdue will compete for that distinction.

The Game

I almost forgot to write about a mostly forgettable game. The offensive brain trust decided to run on a Moo U. defense that had proven itself ineffectual against the run, largely eschewing the unproductive, albeit expensive receiving corps. Evan Grunkemeyer threw only thirteen passes all day, completing eight, including a 75-yard TD toss to a wide-open Davonte Ross. Kaytron Allen ran for 181 yards and two touchdowns, while Nick Singleton added 56.

Meanwhile, on defense against Moo U.’s incompetent offense, Dani Dennis-Sutton showed signs of life with two sacks, two solo tackles, two TFLs, and a punt block. The usually docile Penn State pass rush recorded five sacks on hapless Alessio Milivojevic, a game warrior who had the shit kicked out of him regularly and often.

The Celebration

As the clock ticked down to the final seconds with a win assured, happy chaos ensued on the Nittany Lion sideline, including a purple Gatorade bath for Terry Smith. Happy and relieved players carried Smith off the field as if they had just won the national championship trophy as the culminating moment in the perfect campaign of all those pre-season expectations. In reality, they had just won the god-awful Land Grant Trophy, elevating their dismal record to 4-6, sublimating their disappointing asses out of the Big Ten basement with their only conference victory.

What lies ahead is a winnable game against Raiola-less Nebraska back home at West Shore Home Field at Beaver Stadium, followed by Thanksgiving weekend in Piscataway, a dream destination that could possibly spell the difference between a losing season and dubious bowl eligibility. Now that Lions suddenly reacquainted themselves with the joy of victory after two months of the agony of defeat, the sky’s the limit.

That sky might be a gray, mid-December Bronx sky facing Clemson in a frigid Pin-Stripe Bowl in Yankee Stadium. Or not.

I’ll be back mid-week to assess the Nittany Lions chances against Big Red.

The post Perfect Record Spoiled! appeared first on The Nittany Turkey.

The Attempted Buyout, or: The Time Someone Tried to Buy the Turkey

Let’s begin with the detail that even I found surreal.

Some time after the original post started gaining traction, I received an unsolicited email from a lawyer in Israel. A very polite lawyer. Very formal. Very interested in acquiring my domain name — nittanyturkey.com — for the nice round sum of $10,000.

Now, my site is a charming assortment of Penn State football pessimism, GLP-1 rants, turkey jokes, and occasional tech tirades. It is not, shall we say, a prime target for Middle Eastern private equity.

So I naturally wondered: “Who the hell is behind this?”

No names were offered. No explanation provided. But the context was hard to ignore:

• The Tollman family has deep ties in Israel.
• The Tollman-Hundley saga was suddenly getting unwanted visibility.
• My post, inconveniently accurate and inconveniently discoverable, was still out there.
• And someone was willing to throw five figures at a random blog to make it all go away.

I played along. “Sure,” I said. “$10K for the domain. But the content stays with me.”

And just like that, poof — negotiations over. No counteroffer, no haggling, no “how about $20K?”, nothing. As soon as it became clear the whole post couldn’t be flushed down the digital toilet, the deal evaporated like a fugitive on a private jet.

Everybody has a price, but for this Turkey, ten grand wasn’t it.

The Curious Case of the Disappearing Photo

Years later, I discovered something even stranger: the photo of Monty in the original post had vanished.

Not corrupted. Not mislinked. Just… gone.

I hadn’t removed it. No plugin had eaten it. No server migration had hiccupped.

And yet, the one image someone might want gone — the face attached to a now-inconvenient story — had mysteriously been scrubbed.

I don’t claim this was digital sabotage by well-connected hotel magnates. But let’s just say my WordPress installation on a shared host was hackable enough that someone — human or bot — might have wandered through.

Luckily, I keep backups like a paranoid archivist, and the photo returned to its rightful place. This is my blog, damnit. We restore our own history around here.

Where Monty Ended Up

Monty adjusts the costume on a Bahamian Santa Claus in the mid-1970s.

In 2005, I wrote:

At 68, when he’s released, I hope he still has the drive and desire to come out on top.

Here’s what we know today:

• Monty served his federal sentence (8 years for bank fraud and tax evasion).
• He was housed at FPC Pensacola, as one commenter helpfully posted with full mailing address.
• His projected release was mid-2012.
• After that, he disappeared — quietly, gracefully, intentionally.

No scandals. No comeback tours. No tabloid stories. No book. No Netflix docuseries. Just silence.

People who stumble into my post ask me about him, but I know nothing of his whereabouts or current status.

If he wanted anonymity, he earned it the hard way.

The Comments Section: A Three-Year International Confessional

Now we come to the part that truly deserves documenting, because the comments on that 2005 post evolved into something I can only describe as a Tollman-Hundley Truth and Reconciliation Commission staffed entirely by pseudonyms, ex-employees, ex-family-friends, South African emigres with unresolved rage, and people who knew Monty when he still had hair.

Here’s a sampling of what rolled in over the next several years.

1. The Monty Fans and Loyalists

You’d think I wrote an obituary for Abraham Lincoln judging by some of the reverent tributes.

A cousin wrote that the Monty described in DOJ documents was unrecognizable from the kind man she grew up with.

One Bedford staffer reminisced about Monty calling his son “Grasshopper,” taking peaceful garden walks, and being a devoted father.

Multiple people insisted he was:

• gracious
• humble
• deeply loved
• and ultimately betrayed

One even said:

Monty and Chuck were the fall guys.

Whoever was still rooting for him made themselves heard. (Chuck is Monty’s brother. I met him once or twice.)

2. The Tollman Chronicles: Diet Warlords of South Africa

Holy hell, did the Tollman content snowball.

My blog became the unofficial dumping ground for:

• stories of fleeing Johannesburg “in a hurry,”
• unpaid vendors,
• mansion gossip,
• lavish dinner parties,
• personal betrayals,
• cousin marriages that commenters debated like a backwoods genetics class,
• deep dives into apartheid-era opportunism,
• and philosophical treatises accusing the Tollmans of nouveau-riche colonial decadence.

One ex-employee launched a Molotov cocktail of a comment alleging money laundering, hidden tax shelters, and gold Rolexes, finishing with:

These guys deserve the electric chair.

Subtlety was not a prominent theme.

3. Employees With Battle Scars

Former Days Inn and THH employees showed up with war stories:

• unpaid Social Security taxes
• regional cash flows disappearing into a NY office vortex
• bad internal accounting
• crumbling morale
• over-their-head managers
• conservations like:
  “There’s a difference between can’t pay and won’t pay.”

One GM from the early 2000s even had kind words for Brett Tollman, proving the universe still allows irony.

4. The Soap Opera of SN vs. E.B. McLaughlin

These two practically needed their own corner booth.

• SN wrote cryptically, hinting at secrets, promising revelations, then refusing to spill.
• E.B. accused SN of “obfuscation” and even supplied the dictionary definition.
• SN pushed back.
• E.B. doubled down.
• I sat there, the reluctant kindergarten teacher, reminding the class not to slander anyone.

Had this been in-person, someone would’ve flipped a table.

5. The South African Flame Wars

Enter Walpurgis, who posted an entire Monty Python song beginning with:

I’ve never met a nice South African.

Then we had rebuttals. Counter-rebuttals. Cultural debates. Rage. Poetry. Buddhism. Personal insults.

My Monty Hundley post had somehow become the world’s strangest expat-community bar fight.

6. People Looking for Monty

Dozens of family members and old friends, blindsided by the scandal, arrived searching for him:

• cousins
• high school classmates
• family friends
• people who knew his parents

Some asked for addresses.
Some didn’t know he’d gone to prison.
Some just wanted closure.

The post became a digital missing persons board.

7. The Out-of-Left-Field Voices

These included:

• A builder advertising his Colorado dream home.
• A furious person chanting “Nam-myoho-renge-kyo!” at the Tollmans.
• Generational feuds.
• Class warfare manifestos.
• Genealogy debates.

At one point, I think the thread accidentally summoned a small internet cult.

How My Little Post Became the Nexus

By 2008, I finally admitted the obvious:

I never intended this blog to become the unofficial nexus for Tollman information exchange.”
“This ride has been amazing.”

Amazing is one word for it. A slow-motion train derailment of anecdotes, rage, betrayal, nostalgia, bitterness, affection, and academic treatises on colonialism is another.

But as the curator of this accidental oral history, I’m glad I didn’t delete it.

Stanley Tollman, pictured above, passed away at the age of 91 in 2021.

Final Reflections, 20 Years Later

That 2005 post was about Monty — the talented, complex, flawed man I worked with thirty years beforehand. The man who taught me more about hotel operations and accounting than any classroom ever could. The man I remembered as confident, charismatic, and destined for greatness before life went sideways.

I didn’t expect:

• a domain-buyout attempt,
• a mysterious photo deletion,
• waves of diaspora commentary,
• South African political warfare in my comments,
• ex-employees confessing decades later,
• relatives searching for closure,
• or three years of globe-spanning theater beneath my humble Turkey brand.

But here we are.

I truly hope Monty lived a quiet, peaceful post-release life and I hope his family found closure. I also hope the Tollmans eventually made peace with their choices, fortunes, and consequences.

And I hope the comments section — raw, chaotic, deeply human — stands as a record of the strange, interconnected lives orbiting one man’s rise and fall.

Because in the end?

My little post did something the DOJ never managed:
It captured the human fallout.

Not the legal summary.
Not the headlines.
The human ripples.

Twenty years later, that’s worth preserving.

The post Twenty Years Later: Revisiting Monty, Tollman, and the Blog Post That Wouldn’t Die appeared first on The Nittany Turkey.

For All the Marbles (But No Room Left on the Trophy)

Saturday brings us the almost annual contrived rivalry meeting between Penn State and Michigan State — two proud land-grant institutions, now reduced to clawing at each other like raccoons over a dumpster buffet, fighting for a trophy that looks like it was assembled during an eighth-grade shop class gone horribly wrong.

Yes, the Land-Grant Trophy — the late George Perles’s magnum opus of mahogany mediocrity. A lopsided shrine to bad carpentry, adorned with tourist postcards, dime-store figurines, and topped with the same plastic football player that came on the participation trophies handed out at Pee Wee banquets in 1967. The only thing missing is the bag of marbles this game is allegedly played for, but apparently there wasn’t room between the Nittany Lion bookend and the bust of Sparty that looks like it was rescued from a garage sale.

What if some enterprising, latter-day Nittany Lion or Spartan masochist were to take on the task of updating the trophy to include a drawer for all the marbles? Boy, then we’d really have a trophy worth playing for! Have we lost our marbles? You betcha! Dayummm!

The Combatants (Dumb and Dumber)

Both teams come into this titanic struggle with identical records of 3-6 and both are at 0–6 in Big Ten play, tied for last place with hapless Purdue and fighting to avoid the ceremonial basement broom. Penn State’s offense sputters like a ‘72 Vega, while Moo U’s defense couldn’t stop a cold front. If you’re looking for elite football, try watching Antiques Roadshow — the appraisals are faster-paced.

Vegas, in its infinite optimism, opened the line with Penn State favored by 7.5 points. This feels generous, considering neither team has demonstrated the will to live, much less to score. The over/under is 48.5, which would require both teams to find the end zone more than twice — doable, but subject to more variables than the Econometric Model of the United States.

To add to its offensive woes, Moo U. has a quarterback problem. Starter Aidan Chiles was benched for the Minnesota game due to declining performance in the wake of a hard hit he suffered against UCLA. The unpronounceable but proud Croatian (I’m guessing) redshirt freshman Alessio Milivojevic (mi-li-vo-YEV-ich, maybe) started against Minnesota. Moo U. head coach Jonathan Smith hasn’t commented on whether Milivojevich will be the #1 guy or whether he’ll employ a QB rotation. “They both have skill sets,” Smith muttered.

Nittany Turkey Keys to the Game

1. Don’t Win.
Possession of the Land-Grant Trophy comes with the solemn responsibility of finding somewhere to store the damned thing. Facilities directors have nightmares about it. Michigan State once stashed it behind a water heater for two years before anyone noticed.

2. Don’t Turn the Ball Over — Unless You’re Handing It to the Referee to End the Game.
Punting early and often might be the best strategy. Whoever ends up with the fewest offensive snaps might also end up with their dignity intact.

3. Keep the Trophy Hidden.
If Penn State wins, Terry Smith should accidently on purpose forget to put it on the plane back to University. If the baggage handlers ignore his orders, the equipment manager should drop it off at the Penn State University Composting Facility on the way back to campus from the airport.

Da Wedda

Surprisingly, after the weekend snow, the weather is forecast to be relatively mild for the game. Partly cloudy, with a high of 54 and some showers late in the day that might impact both incompetent offenses.

Da Bottom Lion

Here is where we end the sarcasm and get serious. Or not. Yea, verily, we have reached the part where the summary sentence will be delivered. Indeed, ’tis time for the Official Turkey Poop Prediction, which is worth its weight in electrons perturbed during its creation.

Regardless of the winner, the Land-Grant Trophy will once again find itself wedged awkwardly in a storage closet between the blocking sled and a box of broken chin straps — exactly where it belongs. All will be right with the world. So yes, the game matters, technically. But as Chico Harlan of the Pittsburgh Post-Gazette once put it, the trophy looks like “an oversized Rubik’s Cube after five minutes in the mouth of a rottweiler.” That’s the spirit of the thing right there.

Enough with the Trophy, Let’s Get to the Michigan State Game, Already!

The opening spread favored Penn State by 7.5 in the Battle for the Bottom with an over/under of 48.5. ESPN’s Peter Meter gives Penn State a 79.3% chance of winning. That’s a lot of undue respect from the gambling and sports media communities.

Let’s do some sports psycho-babble analysis involving who will wind up with no conference wins. Each team would need to run the table to get to a 6-6 record, and neither will. They don’t get to draw positions for draft choices like the NFL (yet), so not good reason to tank games either. Moo U will definitely lose to Iowa, and PSU will lose to Nebraska. That leaves beatable Maryland for Moo U and beatable Rutgers for Penn State. Thus, Saturday’s game is the proverbial rubber match. It determines who might share the Big Ten cellar with god-awful Purdue. The Boilermakers are at 0-7 with potential losses to Washington and Indiana remaining.

And so…

The Lions will probably stumble their way to an ugly 20–16 win, helped by Moo U’s legendary ability to self-destruct in the fourth quarter. However, the true loser will be whichever poor Penn State equipment manager has to haul the cubic monstrosity back to State College. I’m inclined to take the under.

I’ll be back after the game with something interesting to say, or maybe I’ll be asleep.

The post The Battle for The Landfill Trophy appeared first on The Nittany Turkey.